Individual
MRS. PRINSCILLIA DENISE SUMPTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 CHILDREN LANE, ST. STEPHENS, SC 29476
(843) 518-7238
Mailing address
PO BOX 9, RUSSELLVILLE, SC 29476-0009
(843) 518-7238
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
SC
172V00000X
Community Health Worker
—
SC
251B00000X
Case Management Agency
Primary
—
SC
251E00000X
Home Health Agency
—
SC
253Z00000X
In Home Supportive Care Agency
116708
SC
313M00000X
Nursing Facility/Intermediate Care Facility
124100
SC
376K00000X
Nurse's Aide
124100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80-0204696
NO MEDICAL PROVIDER
SC
Enumeration date
06/18/2018
Last updated
05/06/2021
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