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General NPI Number Information
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NPI Number | 1578968947
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Entity Type | Individual
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Provider Name | MARY PIPPIN RN
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 2213 ISLAND FORD RD
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City | NINETY SIX
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State | SC
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Zip | 29666-9137
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Country | US
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Telephone | 864-942-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 2213 ISLAND FORD RD
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City | NINETY SIX
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State | SC
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Zip | 29666-9137
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Country | US
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Telephone |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 107183
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License Number State | SC
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