Individual
KANDY STEVENSON-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
140 TOKEENA RD, SENECA, SC 29678-1744
(864) 882-1642
Mailing address
102 WILLOW COR, PIEDMONT, SC 29673-8396
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22175
SC
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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