Organization
SRP MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA R PUCKETT APRN-AGACNP (OWNER)
(407) 516-3756
Entity
Organization
Contact information
Practice address
1445 BLUEWATER WAY, CHARLESTON, SC 29414-7923
(407) 516-3756
Mailing address
742 SAINT ANDREWS BLVD, CHARLESTON, SC 29407-7169
(407) 516-3756
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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