Individual
STEPHANIE BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
735 MCMILLAN ROAD, CLEMSON, SC 29634-0001
(864) 656-2233
(864) 656-0760
Mailing address
BOX 344054, CLEMSON, SC 29634-0001
(864) 656-2233
(864) 656-0760
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207889
SC
363LF0000X
Family Nurse Practitioner
Primary
25154
SC
Other
Enumeration date
07/10/2020
Last updated
11/21/2022
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