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General NPI Number Information
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NPI Number | 1699581181
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Entity Type | Organization
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Legal Business Name | PREMIER PRIMARY CARE LLC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 128 MILLPORT CIRCLE SUITE 200 PMB 8033
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City | GREENVILLE
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State | SC
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Zip | 29607
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Country | US
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Telephone | 864-376-1599
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Fax | 864-448-1636
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Provider Business Mailing Address
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Address Line | 128 MILLPORT CIR STE 200
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City | GREENVILLE
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State | SC
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Zip | 29607-5573
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Country | US
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Telephone | 864-376-1599
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Fax | 864-448-1636
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Authorized Official
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Title or Position | OWNER, NURSE PRACTITIONER
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Name | KATHERINE BARNES
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Credential | FNP-C
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Telephone | 864-376-1599
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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 |
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License Number State |
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