Individual
BRANDEIS K FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1203 EAST CHEVES STREET, FLORENCE, SC 29506-2711
(843) 777-2564
(843) 777-5135
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-2564
(843) 777-5135
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1010
—
SC
Enumeration date
07/12/2006
Last updated
03/27/2009
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