Healthcare Provider Details

I. General information

NPI: 1982230959
Provider Name (Legal Business Name): CASSANDRA TREADWELL GROVER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635A HIGHWAY 28 BYP
ANDERSON SC
29624-3009
US

IV. Provider business mailing address

635A HIGHWAY 28 BYP
ANDERSON SC
29624-3009
US

V. Phone/Fax

Practice location:
  • Phone: 864-772-8173
  • Fax: 833-996-1161
Mailing address:
  • Phone: 864-772-8173
  • Fax: 833-996-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23832
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: