Individual
TIFFANY DELORIS RAVENELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
101 ASHLEY BLUFFS RD, SUMMERVILLE, SC 29485-6043
(843) 826-7716
Mailing address
101 ASHLEY BLUFFS RD, SUMMERVILLE, SC 29485-6043
(843) 285-8131
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
44261
SC
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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