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NPI Code Detail

MEDICARE: CERYL PATRICE SMALLS RN

MEDICARE: CERYL PATRICE SMALLS RN
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
1163WM0705XMedical-Surgical Registered Nurse255534SC

General Provider Information

NPI Number : 1801729066
Entity Type Code : Individual
Provider Name (Legal Business Name) : CERYL PATRICE SMALLS RN
Provider Business Mailing Address
First Line : 8664 WINDSOR HILL BLVD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29420-8458
Country : US
Telephone Number : 843-452-4721
Fax Number :
Provider Business Practice Location Address
First Line : 109 BEE ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29401-5703
Country : US
Telephone Number : 843-577-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2026
Last Update Date : 06/06/2026

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