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NPI Code Detail

MEDICARE: CATHERINE GRAVES HUMPHREYS NP

MEDICARE: CATHERINE GRAVES HUMPHREYS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner3546SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457526840
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE GRAVES HUMPHREYS NP
Provider Business Mailing Address
First Line : 1 INDEPENDENCE PT STE 212
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-4536
Country : US
Telephone Number : 864-797-6303
Fax Number :
Provider Business Practice Location Address
First Line : 890 W FARIS RD STE 100
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4285
Country : US
Telephone Number : 864-455-2888
Fax Number : 864-455-2885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2008
Last Update Date : 03/17/2018

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