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General NPI Number Information
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NPI Number | 1093678807
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Entity Type | Individual
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Provider Name | SUZANNA MONTES BRAN
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Gender | Female
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 413 STATE RD
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City | DILLON
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State | SC
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Zip | 29543
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Country | US
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Telephone | 843-774-2742
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Fax | 843-774-2742
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Provider Business Mailing Address
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Address Line | 134 GRICES FERRY CT
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City | MULLINS
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State | SC
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Zip | 29574-5999
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Country | US
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Telephone | 854-208-3907
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Fax | 854-208-3907
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 52163
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License Number State | SC
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