Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 21156 | SC |
NPI | 1225550700 |
---|---|
Provider Name | Segee Raquel Holley |
First Address | Florence, SC 29506-2617 |
Second Address | Florence, SC 29506-2617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2017 |
Last Update Date | 17/07/2017 |