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General NPI Number Information
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NPI Number | 1346580784
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Entity Type | Individual
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Provider Name | SUSAN GAIL MCWILLIAM BN MS APRN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 1762 E MAIN ST
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City | SPARTANBURG
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State | SC
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Zip | 29307-2231
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Country | US
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Telephone | 864-591-2261
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Fax | 864-591-2271
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Provider Business Mailing Address
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Address Line | 1818 HENDERSON ST
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City | COLUMBIA
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State | SC
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Zip | 29201-2619
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Country | US
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Telephone | 803-758-2600
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Fax | 803-253-8896
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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 | 17921
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License Number State | SC
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