Healthcare Provider Details

I. General information

NPI: 1629988175
Provider Name (Legal Business Name): LATONNA PEARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 OLD MILL RD
SAINT STEPHEN SC
29479-3002
US

IV. Provider business mailing address

1207 OLD MILL RD
SAINT STEPHEN SC
29479-3002
US

V. Phone/Fax

Practice location:
  • Phone: 843-205-9001
  • Fax:
Mailing address:
  • Phone: 843-205-9001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: