Healthcare Provider Details

I. General information

NPI: 1730506502
Provider Name (Legal Business Name): ELIZABETH POSEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 STAR RD
EDGEFIELD SC
29824-4209
US

IV. Provider business mailing address

21 STAR RD
EDGEFIELD SC
29824-4209
US

V. Phone/Fax

Practice location:
  • Phone: 803-637-4035
  • Fax: 803-637-4039
Mailing address:
  • Phone: 803-637-4035
  • Fax: 803-637-4039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR 96199
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: