Individual
MS. STEPHANIE MARIE BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
711 S PARSONAGE ST, BENNETTSVILLE, SC 29512-4423
(843) 479-6801
Mailing address
PO BOX 435, SOCIETY HILL, SC 29593-0435
(843) 676-5865
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
228133
SC
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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