Healthcare Provider Details

I. General information

NPI: 1770496366
Provider Name (Legal Business Name): JOSHUA CURTIS EIDSON APRN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 INTERNATIONAL DR
GREENVILLE SC
29615-4816
US

IV. Provider business mailing address

247 OAK RIDGE DR
GREENWOOD SC
29649-3430
US

V. Phone/Fax

Practice location:
  • Phone: 864-234-7654
  • Fax:
Mailing address:
  • Phone: 864-980-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number32454
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: