Healthcare Provider Details

I. General information

NPI: 1467897876
Provider Name (Legal Business Name): MRS. KAYE GOWAN BELUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 FOSTER ST COWPENS MIDDLE SCHOOL
COWPENS SC
29330-8901
US

IV. Provider business mailing address

150 FOSTER ST COWPENS MIDDLE SCHOOL
COWPENS SC
29330-8901
US

V. Phone/Fax

Practice location:
  • Phone: 864-279-6400
  • Fax: 864-279-6455
Mailing address:
  • Phone: 864-279-6400
  • Fax: 864-279-6455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number50831
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: