Healthcare Provider Details

I. General information

NPI: 1902464738
Provider Name (Legal Business Name): STEPHANIE LYN BUHR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 WOODSIDE AVE
GREENVILLE SC
29611-3733
US

IV. Provider business mailing address

16 DRUID ST
GREENVILLE SC
29609-3821
US

V. Phone/Fax

Practice location:
  • Phone: 864-537-0159
  • Fax:
Mailing address:
  • Phone: 770-503-5196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24933
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: