Healthcare Provider Details

I. General information

NPI: 1760349591
Provider Name (Legal Business Name): DELIA DEONCA TWITTY CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 JENNA LN
LANCASTER SC
29720-3401
US

IV. Provider business mailing address

1816 JENNA LN
LANCASTER SC
29720-3401
US

V. Phone/Fax

Practice location:
  • Phone: 803-577-6225
  • Fax:
Mailing address:
  • Phone: 803-577-6225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number1102488
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: