Basic Information
| Provider Information | |||||||||
| NPI: | 1295961985 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BETHEA | ||||||||
| FirstName: | ORRAN | ||||||||
| MiddleName: | CORRETTA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | DILLON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295363241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438411598 | ||||||||
| FaxNumber: | 8438450758 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 E CHEVES ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295062617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437772000 | ||||||||
| FaxNumber: | 8437772000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2009 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 20684 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 89851 | SC | N | Nursing Service Providers | Registered Nurse |
No ID Information.