Healthcare Provider Details

I. General information

NPI: 1386167757
Provider Name (Legal Business Name): LINDSEY ELIZABETH WASSON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 POWDERSVILLE RD STE G
EASLEY SC
29642-3703
US

IV. Provider business mailing address

838 POWDERSVILLE RD STE G
EASLEY SC
29642-3703
US

V. Phone/Fax

Practice location:
  • Phone: 864-850-9988
  • Fax: 864-850-9989
Mailing address:
  • Phone: 864-850-9988
  • Fax: 864-850-9989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21055
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: