Individual
MARIA REGINA VIDANES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 TRADITIONS WAY, COLUMBIA, SC 29229-7426
(803) 708-2795
Mailing address
601 TRADITIONS WAY, COLUMBIA, SC 29229-7426
(803) 708-2795
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
95871
SC
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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