Healthcare Provider Details

I. General information

NPI: 1275600991
Provider Name (Legal Business Name): CARRIE ANNE TURNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 LINER DR
GREENWOOD SC
29646-2311
US

IV. Provider business mailing address

103 LINER DR
GREENWOOD SC
29646-2311
US

V. Phone/Fax

Practice location:
  • Phone: 864-227-3636
  • Fax: 864-227-6116
Mailing address:
  • Phone: 864-227-3636
  • Fax: 864-227-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1180
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: