Healthcare Provider Details

I. General information

NPI: 1366546566
Provider Name (Legal Business Name): CATHERINE D LUMPKIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HIGHMARKET ST SUITE 200
GEORGETOWN SC
29440-3227
US

IV. Provider business mailing address

PO BOX 2900 1200 HIGHMARKET STREET SUITE 200
GEORGETOWN SC
29442-2900
US

V. Phone/Fax

Practice location:
  • Phone: 843-546-8421
  • Fax: 843-546-1173
Mailing address:
  • Phone: 843-546-8421
  • Fax: 843-546-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number688
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: