Provider Demographics
NPI:1154859502
Name:VANN, FLORENCE MACK (RN)
Entity Type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:MACK
Last Name:VANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9359
Mailing Address - Country:US
Mailing Address - Phone:843-860-0274
Mailing Address - Fax:888-848-8429
Practice Address - Street 1:1041 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9359
Practice Address - Country:US
Practice Address - Phone:843-860-0274
Practice Address - Fax:888-848-8429
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29447163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse