Provider Demographics
NPI:1225368244
Name:GEORGES, SANDRA CARCHELIA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CARCHELIA
Last Name:GEORGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:CARCHELIA
Other - Last Name:VEREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 POWDERHORN RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3399
Mailing Address - Country:US
Mailing Address - Phone:864-963-3421
Mailing Address - Fax:864-962-0758
Practice Address - Street 1:20 POWDERHORN RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3399
Practice Address - Country:US
Practice Address - Phone:864-963-3421
Practice Address - Fax:864-962-0758
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC47207163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse