Individual
AMANDA MILES HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 CARVER ST, LAKE CITY, SC 29560-3283
(843) 374-8651
Mailing address
311 CARVER ST, LAKE CITY, SC 29560-3283
(843) 374-8651
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
92382
SC
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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