Healthcare Provider Details

I. General information

NPI: 1427677855
Provider Name (Legal Business Name): BARBARA JEAN CASPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 CLOISTERS DR
FLORENCE SC
29505-3606
US

IV. Provider business mailing address

920 CLOISTERS DR
FLORENCE SC
29505-3606
US

V. Phone/Fax

Practice location:
  • Phone: 843-662-0828
  • Fax:
Mailing address:
  • Phone: 843-662-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number42740
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: