Individual
HEATHER OAKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
308 EQUINOX CIR, LADSON, SC 29456-5290
(843) 754-4406
(844) 256-1511
Mailing address
PO BOX 1030, WATERTOWN, SD 57201-6030
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P009806
SD
Other
Enumeration date
12/21/2018
Last updated
01/20/2021
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