Healthcare Provider Details

I. General information

NPI: 1972797934
Provider Name (Legal Business Name): MRS. KAREN LEE FAWCETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREN LEE WHITE APRN

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182C SEA ISLAND PKWY
BEAUFORT SC
29907-1503
US

IV. Provider business mailing address

407 BATTERY CREEK RD
BEAUFORT SC
29902-5962
US

V. Phone/Fax

Practice location:
  • Phone: 843-322-1933
  • Fax:
Mailing address:
  • Phone: 843-986-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3341
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: