Doctor Name: | DR. STEPHANIE BROOKE HUSTON |
NPI Number: | 1083963144 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | APRN 18001 |
Business Practice Address: | 1008 Lake Murray Blvd Irmo, SC - 290632821 |
Business Phone Number: | 8037493843 |
Business Fax Number: | |
Mailing Address: | 500 S Bull St, COLUMBIA |
State: | SC |
Postal Code: | 292053752 |
Phone Number: | 3215434974 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2012 |
NPI Last Update Date: | 09/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APRN 18001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |