Healthcare Provider Details

I. General information

NPI: 1700548948
Provider Name (Legal Business Name): STEP WRIGHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 HIGHWAY 72 221 E STE N
GREENWOOD SC
29649-9722
US

IV. Provider business mailing address

720 MONTAGUE AVE # 208
GREENWOOD SC
29649-1439
US

V. Phone/Fax

Practice location:
  • Phone: 864-387-1116
  • Fax:
Mailing address:
  • Phone: 864-387-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MORIAH WRIGHT
Title or Position: OWNER
Credential:
Phone: 864-344-1526