Provider Demographics
NPI:1740303775
Name:JAMES, NANCY RAVENEL
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:RAVENEL
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 MAYBANK HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2115
Mailing Address - Country:US
Mailing Address - Phone:843-762-1177
Mailing Address - Fax:
Practice Address - Street 1:1919 MAYBANK HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2115
Practice Address - Country:US
Practice Address - Phone:843-762-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management