Provider Demographics
NPI:1740710722
Name:CAIN, CARRIE BISHOP (NP-C)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:BISHOP
Last Name:CAIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ELAINE
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:811 W MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2500
Practice Address - Country:US
Practice Address - Phone:038-358-6420
Practice Address - Fax:803-358-6450
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF05170251363LF0000X
SC21254363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily