Individual
MINNIE MAXINE CLEVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9 RICHLAND MEDICAL PARK - SUITE 305, PALMETTO HEALTH RICHLAND - DIABETES EDUCATION, COLUMBIA, SC 29203-6863
(803) 434-7027
(803) 434-1239
Mailing address
5 RICHLAND MEDICAL PARK DR, PALMETTO HEALTH RICHLAND - DIABETES EDUCATION, COLUMBIA, SC 29203-6863
(803) 434-7027
(803) 434-1239
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
R41003
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DPE012
—
SC
Enumeration date
03/15/2007
Last updated
07/09/2007
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