Provider Demographics
NPI:1750623484
Name:BLAND, MARY JOYCE (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JOYCE
Last Name:BLAND
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LYME BAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-0915
Mailing Address - Country:US
Mailing Address - Phone:803-422-1367
Mailing Address - Fax:
Practice Address - Street 1:700 KNOX ABBOTT DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29033-3340
Practice Address - Country:US
Practice Address - Phone:803-939-8400
Practice Address - Fax:803-939-8408
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54233163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health