Healthcare Provider Details

I. General information

NPI: 1114354560
Provider Name (Legal Business Name): CATHERINE M BARTYNSKI AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 PROFESSIONAL PARK DR
CONWAY SC
29526-9261
US

IV. Provider business mailing address

135 PROFESSIONAL PARK DR
CONWAY SC
29526-9261
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-2450
  • Fax:
Mailing address:
  • Phone: 843-347-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number32849
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: