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Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1548256761

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
Tel: 803-751-6475  Fax: 803-751-5242

Contact information for business:
Tel: 803-751-6475  Fax: 803-751-5242

Registration Information:
NPI: 1548256761
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Legacy codes, insurance codes and state license numbers:



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