Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 20923 | SC |
NPI | 1003336488 |
---|---|
Provider Name | Mrs. Pamela Carraway Hitt |
First Address | Liberty, SC 29657-8832 |
Second Address | Clemson, SC 29631-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2017 |
Last Update Date | 26/06/2017 |