Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 20927 | SC |
NPI | 1013442268 |
---|---|
Provider Name | Betty Gattison |
First Address | Florence, SC 29506-2708 |
Second Address | Florence, SC 29506-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2017 |
Last Update Date | 25/04/2017 |