Individual
MS. GWEN MAYO HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 477-0177
Mailing address
PO BOX 15401, SURFSIDE BEACH, SC 29587-5401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F126
SC
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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