Healthcare Provider Details

I. General information

NPI: 1528304219
Provider Name (Legal Business Name): JOYCE MEANS BREWTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 HOWARD ST SPARTANBURG SCHOOL DISTRICT 7
SPARTANBURG SC
29303
US

IV. Provider business mailing address

PO BOX 970 SPARTANBURG SCHOOL DISTRICT 7
SPARTANBURG SC
29304-0970
US

V. Phone/Fax

Practice location:
  • Phone: 864-594-4493
  • Fax: 864-596-8424
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number34053
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: