1518313576 NPI number — KALIA PRINGLE HAIR LOSS SPECIALIST

Table of content: KALIA PRINGLE HAIR LOSS SPECIALIST (NPI 1518313576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518313576 NPI number — KALIA PRINGLE HAIR LOSS SPECIALIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRINGLE
Provider First Name:
KALIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
HAIR LOSS SPECIALIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PRINGLE
Provider Other First Name:
KALIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
HAIR LOSS SPECIALIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1518313576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
818 VANCE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29163-9348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-617-7817
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
818 VANCE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29163-9348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-617-7817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1744P3200X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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