Individual
MRS. ALICIA DAWN WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
139 MEDICAL CENTER DR, GAFFNEY, SC 29340-4823
(864) 487-7186
(864) 487-7246
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19572
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3288
—
SC
01
—
SC62595096
MEDICARE PIN
SC
01
—
SC62596067
MEDICARE PIN
SC
01
—
SC62596121
MEDICARE PIN
SC
01
—
SC6259J577
MEDICARE PIN
SC
Enumeration date
06/24/2015
Last updated
01/09/2020
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