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VICTORIOUS SUPRENA NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
115 BLARNEY DR STE 209, COLUMBIA, SC 29223-6291
(803) 736-6262
(803) 699-1934
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24006
SC

Other

Enumeration date
04/06/2023
Last updated
04/18/2023
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