Individual
MARY KRISTA COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W HAMPTON ST, DILLON, SC 29536-3333
(843) 774-5611
Mailing address
516 S FRANKLIN DR, FLORENCE, SC 29501-4511
(843) 992-7082
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
213309
SC
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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