Healthcare Provider Details

I. General information

NPI: 1518041946
Provider Name (Legal Business Name): REBECCA HAMILTON PARNELL R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS REBECCA LEE HAMILTON

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 AUTUMN HILL LN
ELGIN SC
29045-8779
US

IV. Provider business mailing address

204 AUTUMN HILL LN
ELGIN SC
29045-8779
US

V. Phone/Fax

Practice location:
  • Phone: 803-788-8157
  • Fax:
Mailing address:
  • Phone: 803-788-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: