Healthcare Provider Details

I. General information

NPI: 1750551735
Provider Name (Legal Business Name): LINDA DENELL HAILES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 OAKWOOD LN APT#10A
FLORENCE SC
29501-7323
US

IV. Provider business mailing address

2220 OAKWOOD LN APT#10A
FLORENCE SC
29501-7323
US

V. Phone/Fax

Practice location:
  • Phone: 843-661-0155
  • Fax: 843-661-0155
Mailing address:
  • Phone: 843-661-0155
  • Fax: 843-661-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: