Individual
MICHAELA OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
228 S MAIN ST, TRAVELERS REST, SC 29690-1814
(864) 610-0838
Mailing address
228 S MAIN ST, TRAVELERS RST, SC 29690-1814
(864) 952-9397
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
22640
SC
363LG0600X
Gerontology Nurse Practitioner
22640
SC
Other
Enumeration date
06/18/2019
Last updated
09/29/2022
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