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NPI Code Detail

MEDICARE: MS. JACQUELINE RUTH STAMPS R.N.

MEDICARE: MS. JACQUELINE RUTH STAMPS R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR26451SC

General Provider Information

NPI Number : 1477674802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELINE RUTH STAMPS R.N.
Provider Business Mailing Address
First Line : 120 HOYLES DR
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-9150
Country : US
Telephone Number : 803-324-1962
Fax Number :
Provider Business Practice Location Address
First Line : 3333 WILKINSON BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-5631
Country : US
Telephone Number : 704-393-7720
Fax Number : 704-393-1227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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