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General NPI Number Information
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NPI Number | 1407199011
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Entity Type | Individual
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Provider Name | SHERESA BLACKMON CATOE DNP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 505 WOODLAND DRIVE
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City | KERSHAW
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State | SC
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Zip | 29067-1704
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Country | US
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Telephone | 803-313-3700
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Fax | 803-289-0909
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Provider Business Mailing Address
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Address Line | 505 WOODLAND DRIVE
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City | KERSHAW
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State | SC
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Zip | 29067-1704
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Country | US
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Telephone | 803-283-7465
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Fax | 877-299-9396
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 18183
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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 | SC18183
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SC18183
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SC18183
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License Number State | SC
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