Provider Demographics
NPI:1992370316
Name:PRITCHARD, CATHERINE RENEE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:RENEE
Last Name:PRITCHARD
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 1:34 SALT CREEK DR E
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-7139
Mailing Address - Country:US
Mailing Address - Phone:843-263-7799
Mailing Address - Fax:
Practice Address - Street 1:595 W CAROLINA AVENUE
Practice Address - Street 2:
Practice Address - City:VARNVILLE
Practice Address - State:SC
Practice Address - Zip Code:29944-2994
Practice Address - Country:US
Practice Address - Phone:803-943-2771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC25104363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program