Provider Demographics
NPI:1568842656
Name:HERSHMAN, CARRIEANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CARRIEANNE
Middle Name:
Last Name:HERSHMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-1609
Mailing Address - Country:US
Mailing Address - Phone:704-842-0091
Mailing Address - Fax:
Practice Address - Street 1:400 S LOGAN ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-1609
Practice Address - Country:US
Practice Address - Phone:704-842-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP43098164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC164W00000XMedicaid