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General NPI Number Information
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NPI Number | 1114636149
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Entity Type | Individual
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Provider Name | LEAH ROSE BUFFINGTON
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Gender | Female
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 10 MCCLENNAN BANKS DR
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City | CHARLESTON
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State | SC
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Zip | 29401-1164
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Country | US
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Telephone | 704-473-0388
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Fax |
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Provider Business Mailing Address
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Address Line | 1162 ELLIOTTS CUT DR
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City | CHARLESTON
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State | SC
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Zip | 29412-8834
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Country | US
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Telephone | 704-473-0388
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Fax |
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 258385
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License Number State | SC
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