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LATAVIA HARRISON I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
529 MILLS AVE, GREENVILLE, SC 29605-4218
(864) 751-6424

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19856
SC

Other

Enumeration date
02/22/2016
Last updated
09/27/2018
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