Healthcare Provider Details

I. General information

NPI: 1134079718
Provider Name (Legal Business Name): ALICIA FAYE CARTRETTE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 FARRAR DR
CONWAY SC
29526-8747
US

IV. Provider business mailing address

872 MCNABB SHORTCUT RD
LORIS SC
29569-7294
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-9487
  • Fax:
Mailing address:
  • Phone: 843-356-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number31445
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: