Individual
LIZZIE S HANNIBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDE
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2200
(803) 395-2237
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 395-2237
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
64789
SC
Other
Enumeration date
12/01/2014
Last updated
01/21/2015
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