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NPI 1184256174

NPI 1184256174 : KEVIN L CROMER NP : SPARTANBURG, SC

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General NPI Number Information
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    NPI Number           |    1184256174
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    Entity Type          |    Individual 
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    Provider Name        |    KEVIN L CROMER NP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/07/2020
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    Last Update Date     |    09/09/2025
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Provider Practice Location Address
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    Address Line         |    104 N DANIEL MORGAN AVE STE 105 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29306-2363
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    Country              |    US
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    Telephone            |    864-365-2729
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    Fax                  |    864-383-5093
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Provider Business Mailing Address
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    Address Line         |    104 N DANIEL MORGAN AVE STE 105 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29306-2363
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    Country              |    US
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    Telephone            |    864-365-2729
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    Fax                  |    864-383-5093
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    23766
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    License Number State |    SC
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