Individual
MRS. TENIKQUA FULLWOOD-MAPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1278 N LAFAYETTE DR, SUMTER, SC 29150-2964
(803) 774-4500
Mailing address
2733 SANDHILL DR, SUMTER, SC 29154-5316
(803) 774-4500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
31415
SC
Other
Enumeration date
01/30/2026
Last updated
01/30/2026
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