Healthcare Provider Details

I. General information

NPI: 1619481421
Provider Name (Legal Business Name): TIA RAMIREZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3781 MCDOWELL LN STE 210
LITTLE RIVER SC
29566-8930
US

IV. Provider business mailing address

506 E CHEVES ST STE 202
FLORENCE SC
29506-2616
US

V. Phone/Fax

Practice location:
  • Phone: 843-366-2940
  • Fax: 843-366-2470
Mailing address:
  • Phone: 843-366-2940
  • Fax: 843-366-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number178400
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60813323
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN26974
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: