Healthcare Provider Details

I. General information

NPI: 1316308794
Provider Name (Legal Business Name): CATHERINE CROSBY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2016
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 OLD TROLLEY RD STE 200
SUMMERVILLE SC
29485-8283
US

IV. Provider business mailing address

1801 OLD TROLLEY RD STE 200
SUMMERVILLE SC
29485-8283
US

V. Phone/Fax

Practice location:
  • Phone: 843-781-0075
  • Fax: 854-222-9097
Mailing address:
  • Phone: 843-781-0075
  • Fax: 854-222-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20004
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number20001
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number20004
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: