| NPI | 1558952952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARANDA SHAYANNICE DENDY Family Nurse Practitioner 864-205-3167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |