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Individual

MRS. STEPHANIE EYVETTE AVERETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
8301 FARROW RD, COLUMBIA, SC 29203-3245
(803) 935-7879
(803) 935-5280
Mailing address
220 FAISON DR, COLUMBIA, SC 29203-3210
(803) 935-7140

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
891
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP1221
SC
Enumeration date
10/04/2006
Last updated
08/21/2020
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