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Individual

MRS. TRACY PRIVETTE GEORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
201 W HAMPTON ST, DILLON, SC 29536-3333
(843) 774-5611
Mailing address
230 CHURCH ST, LATTA, SC 29565-1306
(843) 752-7667

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN1519
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP0575
SC
Enumeration date
09/06/2005
Last updated
07/21/2008
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