Basic Information
Provider Information
NPI: 1891422275
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POSEY
FirstName: RACHEAL
MiddleName: DENISE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 E MCBEE AVE FL 4
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012842
CountryCode: US
TelephoneNumber: 8645228603
FaxNumber:  
Practice Location
Address1: 115 N SUMTER ST STE 110
Address2:  
City: SUMTER
State: SC
PostalCode: 291504968
CountryCode: US
TelephoneNumber: 8037758351
FaxNumber: 8037741512
Other Information
ProviderEnumerationDate: 08/04/2022
LastUpdateDate: 10/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X26310SCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LP2300X26310SCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care

No ID Information.


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