Individual
MS. DALE LULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118
(843) 431-2000
Mailing address
PO BOX 23321, NEW YORK, NY 10087-0332
(803) 533-2200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21933
SC
363LA2100X
Acute Care Nurse Practitioner
Primary
21933
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
05/16/2018
Last updated
10/12/2023
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