Individual
MARIANNE M HAGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
BEAUFORT MEMORIAL EXPRESS CARE & OCCUPATIONAL HEALTH, 974 RIBAUT ROAD, BEAUFORT, SC 29902-5486
(843) 524-3344
(843) 524-5574
Mailing address
955 RIBAUT RD, BMAC CREDENTIALING DEPARTMENT, BEAUFORT, SC 29902-5441
(843) 522-5674
(843) 522-5678
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024172154
VA
363LF0000X
Family Nurse Practitioner
Primary
22013
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22013
STATE LICENSE NUMBER
SC
Enumeration date
11/04/2014
Last updated
09/18/2018
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