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Individual

MANDEESA O ROBINSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
337 MINCY ST, MONCKS CORNER, SC 29461-6494
(843) 343-4835
Mailing address
337 MINCY ST, MONCKS CORNER, SC 29461-6494
(843) 343-4835

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
49734
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
49734
LPN
SC
Enumeration date
12/25/2021
Last updated
12/25/2021
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