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General NPI Number Information
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NPI Number | 1689132201
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Entity Type | Individual
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Provider Name | EDWINA MARIE HALLMAN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 32 RIVER ST
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City | PEAK
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State | SC
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Zip | 29122
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Country | US
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Telephone | 803-945-7475
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Fax | 803-945-0000
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Provider Business Mailing Address
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Address Line | 247 SPRING LN
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City | PROSPERITY
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State | SC
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Zip | 29127-6307
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Country | US
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Telephone | 619-944-5206
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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 | 22678
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License Number State | SC
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