Individual
BEVERLY FILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7753 NORTHSIDE DR, NORTH CHARLESTON, SC 29420-8944
(843) 818-1424
(843) 824-8729
Mailing address
7753 NORTHSIDE DR, NORTH CHARLESTON, SC 29420-8944
(843) 818-1424
(843) 824-8729
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
30672
SC
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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