Provider Demographics
NPI:1316308794
Name:CROSBY, CATHERINE (APRN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CROSBY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 OLD TROLLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8283
Mailing Address - Country:US
Mailing Address - Phone:843-781-0075
Mailing Address - Fax:854-222-9097
Practice Address - Street 1:1801 OLD TROLLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8283
Practice Address - Country:US
Practice Address - Phone:843-781-0075
Practice Address - Fax:854-222-9097
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20004363LF0000X, 363LX0001X
SC20001363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4317Medicaid