Provider Demographics
NPI:1407291479
Name:GARRETT ACADEMY HS
Entity Type:Organization
Organization Name:GARRETT ACADEMY HS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CREVELING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-713-4930
Mailing Address - Street 1:2731 GORDON ST
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-3900
Mailing Address - Country:US
Mailing Address - Phone:843-745-7126
Mailing Address - Fax:843-529-3914
Practice Address - Street 1:2731 GORDON ST
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-3900
Practice Address - Country:US
Practice Address - Phone:843-745-7126
Practice Address - Fax:843-529-3914
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CCSD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR99177163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty