Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1670 | SC |
NPI | 1164514345 |
---|---|
Provider Name | Mrs. Shelley Lovell Coker |
First Address | Florence, SC 29506-2716 |
Second Address | Florence, SC 29506-2617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 12/08/2007 |