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Individual

DOREEN MARY MASSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1510 RIBAUT RD, PORT ROYAL, SC 29935-1403
(843) 770-0676
Mailing address
1510 RIBAUT RD, PORT ROYAL, SC 29935-1403
(437) 700-6768

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24477
SC
363LF0000X
Family Nurse Practitioner
RN115838
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085386985A
GA
Enumeration date
05/12/2006
Last updated
02/24/2021
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