Individual
MRS. SUE CAROL STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2177 BEAVERDAM DR, HARTSVILLE, SC 29550-9521
(843) 332-2801
Mailing address
2177 BEAVERDAM DR, HARTSVILLE, SC 29550-9521
(843) 332-2801
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
437611-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02201650
—
NY
Enumeration date
04/17/2007
Last updated
12/21/2007
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