Provider Demographics
NPI:1720325137
Name:STAPLETON, CATHY TRIPP (LPN)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:TRIPP
Last Name:STAPLETON
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:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-0970
Mailing Address - Country:US
Mailing Address - Phone:864-596-8491
Mailing Address - Fax:
Practice Address - Street 1:698 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2964
Practice Address - Country:US
Practice Address - Phone:864-596-8491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP6245164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse