Individual
LAUREN ASHLEY RAY-VILLALOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 259-5762
Mailing address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 259-5762
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24200
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24200
MEDICAL LICENSE
SC
05
—
NP7097
—
SC
01
—
SCI939
MEDICARE
SC
Enumeration date
02/24/2020
Last updated
09/08/2023
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