Provider Demographics
NPI:1427064971
Name:FERRENCE, CAROL J (NP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:FERRENCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 E CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4312
Mailing Address - Country:US
Mailing Address - Phone:843-332-5111
Mailing Address - Fax:843-383-8991
Practice Address - Street 1:528 E CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4312
Practice Address - Country:US
Practice Address - Phone:843-332-5111
Practice Address - Fax:843-383-8991
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1278363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP022Medicaid
SCAA81809988Medicare PIN
P38523Medicare UPIN