Healthcare Provider Details

I. General information

NPI: 1619752821
Provider Name (Legal Business Name): ELIZABETH HILL YARBOROUGH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 CRANIUM DR STE 106
ROCK HILL SC
29732-3585
US

IV. Provider business mailing address

1658 CRANIUM DR STE 106
ROCK HILL SC
29732-3585
US

V. Phone/Fax

Practice location:
  • Phone: 803-327-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5019196
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number27783
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: