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Individual

CAROLINE GRACE FISCUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-3076
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
242699
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
23928
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AN3108
SC
Enumeration date
02/17/2020
Last updated
01/06/2022
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