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
| License | State | Type | Specialty |
|---|---|---|---|
| 14381 | SC | MD | Continence Care Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Florence, SC · Enterostomal Therapy Registered Nurse in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.