Healthcare Provider Details

I. General information

NPI: 1891133443
Provider Name (Legal Business Name): ELIZABETH HAMER LAW HOLZBACH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S DARGAN ST
FLORENCE SC
29506-2538
US

IV. Provider business mailing address

319 S DARGAN ST
FLORENCE SC
29506-2538
US

V. Phone/Fax

Practice location:
  • Phone: 843-669-4141
  • Fax:
Mailing address:
  • Phone: 843-669-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number30363
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: