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General NPI Number Information
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NPI Number | 1134827017
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Entity Type | Individual
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Provider Name | TONY A EVERATT FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 300 GARLINGTON RD
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City | GREENVILLE
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State | SC
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Zip | 29615-4614
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Country | US
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Telephone | 864-254-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 16 MACDEE WAY
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City | GREENVILLE
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State | SC
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Zip | 29607-4745
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Country | US
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Telephone | 803-645-4634
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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 | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 27068
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 27068
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License Number State | SC
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