Provider Demographics
NPI:1194499897
Name:LEFLER, WANDA LYNN (RN)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:LYNN
Last Name:LEFLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 SINGLEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-5016
Mailing Address - Country:US
Mailing Address - Phone:843-745-2000
Mailing Address - Fax:843-745-7191
Practice Address - Street 1:1999 SINGLEY ST
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-5016
Practice Address - Country:US
Practice Address - Phone:843-745-2000
Practice Address - Fax:843-745-7191
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93836163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC93836OtherNURSING LICENSE