Provider Demographics
NPI:1114340304
Name:DINGLE, DENEYA (RN,BSN)
Entity Type:Individual
Prefix:
First Name:DENEYA
Middle Name:
Last Name:DINGLE
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 HOLLY ST W
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:SC
Mailing Address - Zip Code:29924-3156
Mailing Address - Country:US
Mailing Address - Phone:803-943-1059
Mailing Address - Fax:
Practice Address - Street 1:648 PEIRCE RD
Practice Address - Street 2:
Practice Address - City:COTTAGEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29435-5465
Practice Address - Country:US
Practice Address - Phone:843-782-4528
Practice Address - Fax:843-835-2095
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC222535163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse