Individual
LAYNE WINSTEAD VANLIESHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 GROVE RD FL 5, GREENVILLE, SC 29605-4210
(864) 455-4411
(864) 455-4480
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
242634
SC
363LA2100X
Acute Care Nurse Practitioner
22342
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
22342
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5638
—
SC
Enumeration date
08/22/2018
Last updated
09/22/2022
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