Basic Information
| Provider Information | |||||||||
| NPI: | 1447475900 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCLAWHORN | ||||||||
| FirstName: | KRISTEL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JERNIGAN | ||||||||
| OtherFirstName: | KRISTEL | ||||||||
| OtherMiddleName: | L | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 511 PALADIN DRIVE | ||||||||
| Address2: | EASTERN NEPHROLOGY ASSOCIATES | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527528880 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | EASTERN NEPHROLOGY ASSOCIATES, PLLC | ||||||||
| Address2: | 511 PALADIN DRIVE | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278347826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527528880 | ||||||||
| FaxNumber: | 2523172092 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LP00367 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 0116020871 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 2010-00444 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.