Healthcare Provider Details

I. General information

NPI: 1518387281
Provider Name (Legal Business Name): JUNE CAUSEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3956 LONG AVENUE EXT
CONWAY SC
29526-6428
US

IV. Provider business mailing address

3956 LONG AVENUE EXT
CONWAY SC
29526-6428
US

V. Phone/Fax

Practice location:
  • Phone: 843-915-8803
  • Fax: 843-915-6506
Mailing address:
  • Phone: 843-915-8803
  • Fax: 843-915-6506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number45923
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: