Healthcare Provider Details

I. General information

NPI: 1073305520
Provider Name (Legal Business Name): CARLA GIBSON WILLIAMS RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT FRANCIS DR
GREENVILLE SC
29601-3955
US

IV. Provider business mailing address

106 DYER DR
CENTRAL SC
29630-2802
US

V. Phone/Fax

Practice location:
  • Phone: 864-255-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number243396
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: