Healthcare Provider Details
I. General information
NPI: 1871238048
Provider Name (Legal Business Name): STEPHANIE BARNWELL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/03/2022
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 BULL CORNER RD
YEMASSEE SC
29945-7900
US
IV. Provider business mailing address
PO BOX 816
LOBECO SC
29931-0816
US
V. Phone/Fax
- Phone: 843-473-0296
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 164W00000X |
| Taxonomy | Licensed Practical Nurse |
| License Number | P39520 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: