Individual
KIA ANTOINNETTE STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2416 RAMONA DR, DARLINGTON, SC 29532-8131
(843) 453-3629
Mailing address
1341 N CASHUA DR, FLORENCE, SC 29501-6939
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
56060
SC
Other
Enumeration date
11/16/2024
Last updated
11/16/2024
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