Healthcare Provider Details

I. General information

NPI: 1437666427
Provider Name (Legal Business Name): ZANETTA RANDOLPH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZANETTA RIVERS

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W WADE HAMPTON BLVD STE C
GREER SC
29650-1311
US

IV. Provider business mailing address

805 W WADE HAMPTON BLVD STE C
GREER SC
29650-1311
US

V. Phone/Fax

Practice location:
  • Phone: 864-655-6615
  • Fax: 855-617-4423
Mailing address:
  • Phone: 864-655-6615
  • Fax: 855-617-4423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22371
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: