| Doctor Name: | MARY BYRD |
| NPI Number: | 1013320159 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | APRN 18845 |
| Business Practice Address: | 4999 Carolina Forest Blvd Suite 9 Myrtle Beach, SC - 295793587 |
| Business Phone Number: | 8432362700 |
| Business Fax Number: | 8432362726 |
| Mailing Address: | Po Box 6407, FLORENCE |
| State: | SC |
| Postal Code: | 295026407 |
| Phone Number: | 8007416920 |
| Fax Number: | 8436674573 |
| NPI Enumeration Date: | 06/06/2014 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APRN 18845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |