Provider Demographics
NPI:1992587679
Name:GARRETT, GINA ELAINE (BSN, RN, ONC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:ELAINE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:BSN, RN, ONC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 WALLACE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4822
Mailing Address - Country:US
Mailing Address - Phone:843-763-1555
Mailing Address - Fax:843-763-1567
Practice Address - Street 1:1871 WALLACE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4822
Practice Address - Country:US
Practice Address - Phone:843-763-1555
Practice Address - Fax:843-763-1567
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC225160163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool