Healthcare Provider Details

I. General information

NPI: 1124137005
Provider Name (Legal Business Name): KATHRYN JANE ARFLACK APRN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 GROVE RD SUITE B
GREENVILLE SC
29605-4656
US

IV. Provider business mailing address

1 INDEPENDENCE PT SUITE 212
GREENVILLE SC
29615-4545
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-8897
  • Fax:
Mailing address:
  • Phone: 864-797-6044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1756M
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1756M
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1756
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: