Individual
CAYLA BROOKE HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-9104
(843) 792-1414
Mailing address
PO BOX 23321, NEW YORK, NY 10087-4321
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26825
SC
363LF0000X
Family Nurse Practitioner
Primary
26825
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26825
SOUTH CAROLINA BOARD OF NURSING
SC
01
—
F11220527
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
—
Enumeration date
11/28/2022
Last updated
04/07/2025
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