| NPI | 1316455231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE PARKER Nurse Practitioner 803-474-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20218) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2026-02-24 |