Individual
INDIA CAROLINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
2849 LUCILLE DR, COLUMBIA, SC 29204-2731
(803) 463-9051
Mailing address
2849 LUCILLE DR, COLUMBIA, SC 29204-2731
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002102973
VA
Other
Enumeration date
07/27/2026
Last updated
07/27/2026
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