Provider Demographics
NPI:1770560310
Name:KITHCART, ARNELL CORETHIA (FNP)
Entity type:Individual
Prefix:MRS
First Name:ARNELL
Middle Name:CORETHIA
Last Name:KITHCART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ARNELL
Other - Middle Name:CORETHIA
Other - Last Name:HENNEGHAN
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3404 TWIGGS RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-5100
Mailing Address - Country:US
Mailing Address - Phone:843-673-9481
Mailing Address - Fax:843-676-0984
Practice Address - Street 1:2835 E HIGHWAY 76
Practice Address - Street 2:STE 6
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6038
Practice Address - Country:US
Practice Address - Phone:843-431-9882
Practice Address - Fax:843-431-9879
Is Sole Proprietor?:No
Enumeration Date:2005-12-24
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP30301Medicare UPIN