Individual provider Active NPI

Nan Elizabeth Fetters, WHNP

  • Ambulatory Women's Health Care Registered Nurse
  • Mount Pleasant, SC
National Provider Identifier
1861608614
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
License
4704107767 Issued in MI
Practice address
3077 Queensgate Way
Mount Pleasant, SC 29466-9069
Phone
(843) 270-8885
Fax
(843) 856-3760
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 4704107767 MI Primary

Addresses

Primary practice location

3077 Queensgate Way
Mount Pleasant, SC 29466-9069

Mailing address

3077 Queensgate Way
Mount Pleasant, SC 29466-9069
Phone (843) 270-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704107767MIMDAmbulatory Women's Health Care Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861608614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 QUEENSGATE WAY",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669069",
            "telephone_number": "843-270-8885",
            "fax_number": "843-856-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 QUEENSGATE WAY",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669069",
            "telephone_number": "843-270-8885",
            "fax_number": "843-856-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "NAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "MI",
            "license": "4704107767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.