Healthcare Provider Details

I. General information

NPI: 1487410957
Provider Name (Legal Business Name): CALLIE RUMFELT LYEW APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CHEVES ST STE 260
FLORENCE SC
29506-2652
US

IV. Provider business mailing address

2671 FLUSHING COVEY DR
HARTSVILLE SC
29550-8082
US

V. Phone/Fax

Practice location:
  • Phone: 843-665-7941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.28393
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: