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Individual

LEA CALLCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
890 W FARIS RD STE 580, GREENVILLE, SC 29605-4281
(864) 455-7874
(864) 455-8933
Mailing address
5570 CREPE MYRTLE RD, YORK, SC 29745-9674

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
31142
SC
363LG0600X
Gerontology Nurse Practitioner
31142
SC

Other

Enumeration date
10/22/2025
Last updated
01/23/2026
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