Individual
STACIE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-5611
(864) 458-8544
Mailing address
315 CRESTHAVEN PL, SIMPSONVILLE, SC 29681-4854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
17539
SC
Other
Enumeration date
01/24/2011
Last updated
08/23/2011
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