Provider Demographics
NPI:1457753378
Name:HRYSIKOS, RAMONA R (RN ,DCES)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:R
Last Name:HRYSIKOS
Suffix:
Gender:F
Credentials:RN ,DCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-585-8221
Practice Address - Fax:864-542-9859
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC70358163WD0400X
SC20120385163WD0400X
SC25737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC70358Other205511312
SCNP8614Medicaid
SCSCN2573365OtherMEDICARE PIN