Individual
ANITA M DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1344 HAILE ST, CAMDEN, SC 29020-3076
(803) 432-1996
(803) 424-2703
Mailing address
PO BOX 1259, CAMDEN, SC 29021-1259
(803) 713-8350
(803) 713-8433
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
954
SC
363LA2100X
Acute Care Nurse Practitioner
AC52783
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500021206
RAILROAD MEDICARE PIN
SC
05
—
NP0204
—
SC
Enumeration date
05/17/2006
Last updated
09/28/2015
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