Provider Demographics
NPI:1760720262
Name:SYRING-NEMITZ, MELINDA DENE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:DENE
Last Name:SYRING-NEMITZ
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 APPLE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-9402
Mailing Address - Country:US
Mailing Address - Phone:864-205-9768
Mailing Address - Fax:864-577-7629
Practice Address - Street 1:114 APPLE VALLEY RD
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-9402
Practice Address - Country:US
Practice Address - Phone:864-205-9768
Practice Address - Fax:864-577-7629
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC97196163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator