Healthcare Provider Details
I. General information
NPI: 1043047665
Provider Name (Legal Business Name): SHERELLE BROWNING SCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12 ALVIN DR # B
GREENVILLE SC
29605-2201
US
IV. Provider business mailing address
2607 WOODRUFF RD STE E1052
SIMPSONVILLE SC
29681-4803
US
V. Phone/Fax
- Phone: 214-216-2015
- Fax:
- Phone: 214-216-2015
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225500000X |
| Taxonomy | Respiratory/Developmental/Rehabilitative Specialist/Technologist |
| License Number | 91913 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: