Basic Information
| Provider Information | |||||||||
| NPI: | 1629299706 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRICE | ||||||||
| FirstName: | JO | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN,BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 237 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295670237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438417698 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 609 S COIT ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295015222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436628633 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 08/06/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH1000X | 1293 | SC | Y | Nursing Service Providers | Registered Nurse | Hospice |
No ID Information.