Healthcare Provider Details

I. General information

NPI: 1548593122
Provider Name (Legal Business Name): BRENDA ANNE HEWITT FNP-C, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRENDA ANNE PATTERSON FNP-C, MSN

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 POSTAL WAY
MYRTLE BEACH SC
29579-3537
US

IV. Provider business mailing address

300 SINGLETON RIDGE RD ATTENTION PATIENT ACCOUNTING
CONWAY SC
29526-9142
US

V. Phone/Fax

Practice location:
  • Phone: 843-236-0000
  • Fax: 843-236-6191
Mailing address:
  • Phone: 843-234-6946
  • Fax: 843-234-8958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number465647-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF339792-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23069
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: