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General NPI Number Information
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NPI Number | 1376299248
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Entity Type | Individual
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Provider Name | RENEE ELIZABETH SUTTON
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 301 E JACKSON ST
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City | DILLON
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State | SC
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Zip | 29536-2509
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Country | US
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Telephone | 843-774-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SYCAMORE AVE APT 436
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City | CHARLESTON
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State | SC
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Zip | 29407-6719
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Country | US
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Telephone | 843-813-9939
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 25851
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License Number State | SC
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