Individual
KASEY BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 N 8TH AVE STE 2B, DILLON, SC 29536-2549
(843) 841-3846
Mailing address
705 N 8TH AVE STE 2B, DILLON, SC 29536-2549
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28517
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
01/15/2026
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