Healthcare Provider Details

I. General information

NPI: 1205650892
Provider Name (Legal Business Name): YVONNE HUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 TWO NOTCH RD STE 5
COLUMBIA SC
29223-1612
US

IV. Provider business mailing address

9600 TWO NOTCH RD STE 5
COLUMBIA SC
29223-1612
US

V. Phone/Fax

Practice location:
  • Phone: 803-801-1175
  • Fax: 803-845-1054
Mailing address:
  • Phone: 803-801-1175
  • Fax: 803-845-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: