Individual
HAILEY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1538 STILLEY CIR, CONWAY, SC 29526-3072
(843) 465-2107
Mailing address
1538 STILLEY CIR, CONWAY, SC 29526-3072
(843) 465-2107
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
217648
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217648
NURSING LICENSE NUMBER
SC
Enumeration date
11/02/2018
Last updated
11/02/2018
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