Provider Demographics
NPI:1528405396
Name:FLOYD, DOROTHY L (RN BSN CRRN)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:L
Last Name:FLOYD
Suffix:
Gender:F
Credentials:RN BSN CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-2822
Mailing Address - Country:US
Mailing Address - Phone:843-355-1506
Mailing Address - Fax:843-355-9207
Practice Address - Street 1:710 3RD AVE
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-2822
Practice Address - Country:US
Practice Address - Phone:843-355-1506
Practice Address - Fax:843-355-9207
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC45623163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool