Healthcare Provider Details

I. General information

NPI: 1538883541
Provider Name (Legal Business Name): RONICE M LAMPKIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 S LIVE OAK DR STE 106
MONCKS CORNER SC
29461-7238
US

IV. Provider business mailing address

2094 S LIVE OAK DR STE 106
MONCKS CORNER SC
29461-7238
US

V. Phone/Fax

Practice location:
  • Phone: 843-737-3782
  • Fax:
Mailing address:
  • Phone: 843-737-3782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number219646
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: