Healthcare Provider Details

I. General information

NPI: 1982020731
Provider Name (Legal Business Name): CATHERINE ELIZABETH MCBRIDE RN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE MCBRIDE MCCASKILL RN MSN

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 N ACLINE ST
LAKE CITY SC
29560-2107
US

IV. Provider business mailing address

137 N ACLINE ST
LAKE CITY SC
29560-2107
US

V. Phone/Fax

Practice location:
  • Phone: 803-683-6940
  • Fax:
Mailing address:
  • Phone: 803-683-6940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number103843
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number103843
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: