Healthcare Provider Details

I. General information

NPI: 1336695618
Provider Name (Legal Business Name): MONTRICE EVETTE CURENTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 02/11/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S SEVENTH ST
MC BEE SC
29101-7101
US

IV. Provider business mailing address

645 S SEVENTH ST
MC BEE SC
29101-7101
US

V. Phone/Fax

Practice location:
  • Phone: 843-335-8291
  • Fax: 843-335-8731
Mailing address:
  • Phone: 843-335-8291
  • Fax: 843-335-8731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20326
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number20326
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number20626
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: