Lisa Weatherford Yascavage, RN

Individual provider Active NPI School Registered Nurse · Warrenville, SC

NPI 1487085734 · NPPES record last updated Dec 11, 2013

Key facts

NPI
1487085734
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
R38395 (GA)
Practice address
569 Howlandville Rd
Warrenville, SC 29851-3430
Phone
(803) 663-4270
Fax
(803) 663-4271
NPI assigned
Dec 11, 2013
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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R38395GAMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X R38395 GA Yes

Addresses

Primary practice location

569 Howlandville Rd
Warrenville, SC 29851-3430

Mailing address

569 Howlandville Rd
Warrenville, SC 29851-3430
Phone (803) 663-4270

Other identifiers

IdentifierTypeStateIssuer
163WA2000XMedicaidSC

Other providers in Warrenville, SC

All providers in Warrenville, SC · School Registered Nurse in South Carolina

Sources for this page

Verify at the official NPI Registry.