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General NPI Number Information
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NPI Number | 1003446998
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Entity Type | Individual
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Provider Name | CASSANDRA NICOLE CALLOWAY FNP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 201 W MEETING ST
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City | LANCASTER
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State | SC
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Zip | 29720-2379
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Country | US
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Telephone | 803-286-4666
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 603898
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City | CHARLOTTE
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State | NC
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Zip | 28260-3898
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Country | US
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Telephone | 843-792-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23521
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License Number State | SC
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