Provider Demographics
NPI:1730522665
Name:HOUGHTALING, KAM (RN)
Entity type:Individual
Prefix:MRS
First Name:KAM
Middle Name:
Last Name:HOUGHTALING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LAKE SECESSION RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-6417
Mailing Address - Country:US
Mailing Address - Phone:864-446-2600
Mailing Address - Fax:864-446-2602
Practice Address - Street 1:104 LAKE SECESSION RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-6417
Practice Address - Country:US
Practice Address - Phone:864-446-2600
Practice Address - Fax:864-446-2602
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68625163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool