Provider Demographics
NPI:1528151255
Name:KNIGHT-SCHLONDROP, CAROLYN ANN (NP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:KNIGHT-SCHLONDROP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:KNIGHT
Other - Last Name:HAGLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6326 SAINT ANDREWS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3126
Mailing Address - Country:US
Mailing Address - Phone:803-979-9666
Mailing Address - Fax:800-878-6608
Practice Address - Street 1:6326 SAINT ANDREWS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3126
Practice Address - Country:US
Practice Address - Phone:803-979-9666
Practice Address - Fax:800-878-6608
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC03004363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA22619610OtherMEDICARE SC PTAN 9610
SCAA22619610OtherMEDICARE SC PTAN 9610