| NPI | 1962260232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANETHEA BRYANTLORD Business Owner 803-243-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management |
| 163WG0000X Registered Nurse, General Practice | |
| 163WG0600X Registered Nurse, Gerontology | |
| 163WN1003X Registered Nurse, Nutrition Support | |
| 164W00000X Licensed Practical Nurse | |
| 171400000X Health & Wellness Coach | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-05-16 |