Ralph Lee Baisden Jr., FNP
Nurse Practitioner, Family in Simpsonville, SC. Individual provider (NPI-1).
NPI number1275634784
StatusActive
Last updated in NPPESJul 19, 2021
Details
- NPI
- 1275634784
- Entity type
- Individual (NPI-1)
- Name
- Ralph Lee Baisden Jr.
- Credential
- FNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 26, 2006
- Certification date
- Jul 19, 2021
- Last updated
- Jul 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 20736 | SC | Yes |
| 363LF0000X | Nurse Practitioner, Family | ARNP1175352 | FL |
Practice location
1409 W Georgia Rd Ste BSimpsonville, SC 29680-6420
Phone 864-454-5000 · Fax 864-241-9231
Mailing address
300 E McBee Ave Fl 4Greenville, SC 29601-2842
Phone 864-522-8603
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