Individual
JUDY R. GULLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 MYRTLE LN, CHESTERFIELD, SC 29709-5153
(843) 680-2633
Mailing address
74 MYRTLE LN, CHESTERFIELD, SC 29709-5153
(843) 680-2633
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
45872
SC
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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