Provider Demographics
NPI:1114440419
Name:WEBB, KRISTIN (NP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:WEBB
Suffix:
Gender:
Credentials:NP
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:LUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:607 WILMINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902
Mailing Address - Country:US
Mailing Address - Phone:843-525-7615
Mailing Address - Fax:
Practice Address - Street 1:136 STONEMARK LN STE 100C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-3881
Practice Address - Country:US
Practice Address - Phone:888-701-4661
Practice Address - Fax:888-239-2595
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC234588163WC1500X
SC27713RX363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP9673Medicaid