Individual
MRS. ELIZABETH JACQUES WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 MEMORIAL MEDICAL CT, GREENVILLE, SC 29605-4449
(864) 272-3409
Mailing address
219 CAMMER AVE, GREENVILLE, SC 29605-1910
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
277767
SC
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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