Provider Demographics
NPI:1598975682
Name:ALTMAN, DENISE M (RN, IBCLC, LCCE)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:M
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:RN, IBCLC, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 DEVINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2402
Mailing Address - Country:US
Mailing Address - Phone:803-479-2327
Mailing Address - Fax:
Practice Address - Street 1:212 S WACCAMAW AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-3334
Practice Address - Country:US
Practice Address - Phone:803-479-2327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC63657163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant