Individual
BRIA TYNEQUA ALLSBROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1324 COMMERCE DRIVE, PILLON, SC 29536
(843) 774-3351
(843) 774-2622
Mailing address
PO BOX 918, BENNETTSVILLE, SC 29512
(843) 544-4060
(843) 454-0635
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
257287
SC
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
257287
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405127
—
SC
Enumeration date
08/03/2021
Last updated
12/13/2023
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