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1174008841
DEIDRA DARE HUCKABEE
SUMMERVILLE, SC
NPI
1174008841
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 77786)
Enumeration Date
2018-09-28
Last Update Date
2018-10-01
Business Address
DEIDRA DARE HUCKABEE DNP
295 MIDLAND PKWY
SUMMERVILLE, SC 29485-8104
Phone number: 843-832-5000
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Mailing Address
DEIDRA DARE HUCKABEE DNP
5870 HIATUS RD
TAMARAC, FL 33321-6424
Phone number: 954-377-2939
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