Provider Demographics
NPI:1538124078
Name:BABINEAU, DENISE M (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:BABINEAU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:MIRELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:117 DUCK BLIND CT
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-2866
Mailing Address - Country:US
Mailing Address - Phone:843-771-1985
Mailing Address - Fax:
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6849
Practice Address - Country:US
Practice Address - Phone:843-434-7151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN2747363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC98FOtherPHX