Individual
GINA M STENSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 E WOOD ST, 3RD FLOOR, SPARTANBURG, SC 29303-3040
(864) 560-1900
(864) 560-1925
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
84212
SC
363L00000X
Nurse Practitioner
19669
SC
363LF0000X
Family Nurse Practitioner
Primary
19669
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3387
—
SC
01
—
SC66093365
MEDICARE PIN
SC
Enumeration date
06/12/2015
Last updated
01/17/2018
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