Individual
MRS. STACEY BUMGARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
222 S HERLONG AVE, ROCK HILL, SC 29732-1158
(803) 329-6754
(803) 985-4521
Mailing address
1410 PARK WALK PL, ROCK HILL, SC 29732-2573
(803) 329-6754
(803) 985-4521
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4035
SC
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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