| NPI | 1326392689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH FAIRCHILDS Mid Level Provider 864-314-9526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN205146) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2013-03-14 |