Basic Information
| Provider Information | |||||||||
| NPI: | 1679954887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMSEY | ||||||||
| FirstName: | DOROTHY | ||||||||
| MiddleName: | STELLA | ||||||||
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| OtherLastName: | RAMSEY | ||||||||
| OtherFirstName: | STELLA | ||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 525 VERDAE BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296074021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8646035600 | ||||||||
| FaxNumber: | 8646035601 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8646035600 | ||||||||
| FaxNumber: | 8646035601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2015 | ||||||||
| LastUpdateDate: | 07/26/2019 | ||||||||
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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 | 163W00000X | 209925 | SC | N | Nursing Service Providers | Registered Nurse | 207R00000X | 19598 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 363L00000X | 19598 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.