Individual
MRS. MARIANNE BUTLER HEERINGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
443 CONGAREE RD, GREENVILLE, SC 29607-2742
(864) 329-7437
Mailing address
154 LAKE LYMAN HTS, LYMAN, SC 29365-9759
(864) 329-7437
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
105134
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105134
SCLLR
SC
Enumeration date
04/02/2020
Last updated
04/02/2020
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