Healthcare Provider Details

I. General information

NPI: 1982421244
Provider Name (Legal Business Name): LAUREN BONVILLE KERFOOT DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 JUSTICE LN
ANDERSON SC
29621-2354
US

IV. Provider business mailing address

8 JUSTICE LN
ANDERSON SC
29621-2354
US

V. Phone/Fax

Practice location:
  • Phone: 864-760-6130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number245156
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: