Individual
MRS. KATIE PRIVETT STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
48 CROSS PARK CT, GREENVILLE, SC 29605-4263
(864) 797-7400
(864) 797-7405
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2271
SC
363AM0700X
Medical Physician Assistant
2271
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2116PA
—
SC
Enumeration date
02/10/2015
Last updated
06/01/2021
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