Individual
ERIC WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1278 N LAFAYETTE DR, SUMTER, SC 29150-2964
(803) 774-4500
(803) 774-4649
Mailing address
1278 N LAFAYETTE DR, SUMTER, SC 29150-2964
(803) 774-4500
(803) 774-4649
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
21399
SC
Other
Enumeration date
04/08/2014
Last updated
10/24/2018
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