Healthcare Provider Details

I. General information

NPI: 1114002003
Provider Name (Legal Business Name): CATHERINE MARIE BURNETT R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SOUTH HERLONG
ROCK HILL SC
29732
US

IV. Provider business mailing address

804 CHIPMEADOW LANE
YORK SC
29745
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-6848
  • Fax: 803-329-6762
Mailing address:
  • Phone: 803-684-7013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number43809
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: