Individual
MRS. PATRICIA MICHELE HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1750 LAUREL ST, COLUMBIA, SC 29201-2625
(803) 779-3378
(803) 779-3103
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
519
SC
363LP2300X
Primary Care Nurse Practitioner
Primary
519
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0497
—
SC
Enumeration date
09/22/2005
Last updated
11/06/2020
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