Healthcare Provider Details

I. General information

NPI: 1093644981
Provider Name (Legal Business Name): CALLIE SWEATT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 REEDY RIVER CT
LEXINGTON SC
29073-9630
US

IV. Provider business mailing address

412 REEDY RIVER CT
LEXINGTON SC
29073-9630
US

V. Phone/Fax

Practice location:
  • Phone: 803-727-5056
  • Fax:
Mailing address:
  • Phone: 803-727-5056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number278107
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: