Doctor Name: | NICOLE R OURS |
NPI Number: | 1053608588 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | |
Business Practice Address: | 10 E Hospital Street Hospitalist Department Manning, SC - 29102 |
Business Phone Number: | 8034358463 |
Business Fax Number: | 8034355288 |
Mailing Address: | 10 E Hospital Street, Hospitalist Department MANNING |
State: | SC |
Postal Code: | 29102 |
Phone Number: | 8034358463 |
Fax Number: | 8034355288 |
NPI Enumeration Date: | 07/05/2011 |
NPI Last Update Date: | 11/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |