Individual
MRS. CAROLYN BIRCHMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1316 N LAKE DR, LEXINGTON, SC 29072-7653
(803) 358-1191
(803) 358-1180
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 358-1191
(803) 358-1180
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F625
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA8494A871
MEDICARE PTAN
SC
05
—
NP0216
—
SC
Enumeration date
04/26/2007
Last updated
04/02/2012
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