Provider Demographics
NPI:1649612979
Name:CALDWELL, AMY HART (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:HART
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 LAURENS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3224
Mailing Address - Country:US
Mailing Address - Phone:864-288-8280
Mailing Address - Fax:
Practice Address - Street 1:109 CARTER PARK DR STE 3A
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1152
Practice Address - Country:US
Practice Address - Phone:864-885-0058
Practice Address - Fax:864-885-0098
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily