Patsy Fulghum, BSN, RN

Individual provider Active NPI Enterostomal Therapy Registered Nurse · Florence, SC

NPI 1194142992 · NPPES record last updated Mar 19, 2014

Key facts

NPI
1194142992
Entity type
Individual (NPI type 1)
Primary specialty
Enterostomal Therapy Registered Nurse 163WE0900X
License
14381 (SC)
Practice address
1705 W Evans St
Florence, SC 29501-3331
Phone
(843) 661-4762
NPI assigned
Mar 19, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
14381SCMDContinence Care Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Continence Care Registered Nurse 163WC2100X 14381 SC
Enterostomal Therapy Registered Nurse 163WE0900X 14381 SC Yes
Home Health Registered Nurse 163WH0200X 14381 SC
Wound Care Registered Nurse 163WW0000X 14381 SC
Ostomy Care Registered Nurse 163WX1500X 14381 SC

Addresses

Primary practice location

1705 W Evans St
Florence, SC 29501-3331

Mailing address

1705 W Evans St
Florence, SC 29501-3331
Phone (843) 661-4762

Other providers in Florence, SC

All providers in Florence, SC · Enterostomal Therapy Registered Nurse in South Carolina

Sources for this page

Verify at the official NPI Registry.