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1124713128
VICTORIOUS SUPRENA NELSON
COLUMBIA, SC
NPI
1124713128
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 24006)
Enumeration Date
2023-04-06
Last Update Date
2023-04-18
Business Address
VICTORIOUS SUPRENA NELSON NP
115 BLARNEY DR STE 209
COLUMBIA, SC 29223-6291
Phone number: 803-736-6262
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Mailing Address
VICTORIOUS SUPRENA NELSON NP
300 E MCBEE AVE FL 4
GREENVILLE, SC 29601-2842
Phone number: 864-522-8603
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