Healthcare Provider Details

I. General information

NPI: 1821330341
Provider Name (Legal Business Name): LEANNE MARIE HARTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 E HOWE SPRINGS RD
FLORENCE SC
29505-6700
US

IV. Provider business mailing address

2300 E HOWE SPRINGS RD
FLORENCE SC
29505-6700
US

V. Phone/Fax

Practice location:
  • Phone: 843-664-8451
  • Fax: 843-664-8182
Mailing address:
  • Phone: 843-664-8451
  • Fax: 843-664-8182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number103603
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: