Individual provider · NPI-1

Bernice Agana

Student in an Organized Health Care Education/Training Program · Charleston, SC

NPI number1790471001
StatusActive
Last updated in NPPESApr 11, 2023

Details

NPI
1790471001
Entity type
Individual (NPI-1)
Name
Bernice Agana
Sex
Female
Sole proprietor
No
Enumeration date
Apr 11, 2023
Certification date
Apr 11, 2023
Last updated
Apr 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

171 Ashley Ave
Charleston, SC 29425-8908

Phone 843-792-2300

Mailing address

2020 Proximity Dr
Charleston, SC 29414-7937

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