Provider Demographics
NPI:1316960081
Name:LEONARD, KRISTINE LOVETT
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:LOVETT
Last Name:LEONARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S BUNCOMBE RD STE D
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-2432
Mailing Address - Country:US
Mailing Address - Phone:864-522-1721
Mailing Address - Fax:864-522-1727
Practice Address - Street 1:845 S BUNCOMBE RD STE D
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2432
Practice Address - Country:US
Practice Address - Phone:864-522-1721
Practice Address - Fax:864-522-1727
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA016895183500000X
SC8032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist