Individual
TANYA WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
318 E MAIN ST, LAKE CITY, SC 29560-2116
(843) 374-2221
Mailing address
PO BOX 1509, LAKE CITY, SC 29560-1509
(843) 374-2221
(843) 374-8967
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
72359
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245288901
—
SC
Enumeration date
05/16/2013
Last updated
05/16/2013
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