LISA FANNING ETHERIDGE

ORANGEBURG, SC
NPI1245784669
Former NameLISA FANNING SMITH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  20081)
Enumeration Date2016-08-15
Last Update Date2022-07-21
Business Address
LISA FANNING ETHERIDGE FNP/APRN
1175 COOK RD STE 320
ORANGEBURG, SC 29118-8247
Phone number: 803-395-3960
Mailing Address
LISA FANNING ETHERIDGE FNP/APRN
914 REYNOLDS RD
BARNWELL, SC 29812
Phone number: 803-259-5311
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