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General NPI Number Information
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NPI Number | 1356053052
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Entity Type | Organization
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Legal Business Name | DIANA DENNISON ENTERPRISE LLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 5460 HIGHMARKET STREET
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City | GEORGETOWN
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State | SC
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Zip | 29440
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Country | US
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Telephone | 843-304-7566
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Fax |
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Provider Business Mailing Address
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Address Line | 5460 HIGHMARKET STREET
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City | GEORGETOWN
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State | SC
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Zip | 29440
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Country | US
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Telephone | 843-304-7566
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER OF BUSINESS
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Name | MS. DIANA DENNISON
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Credential | CNA/MED-TECH
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Telephone | 843-304-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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