Individual provider · Type 1 NPI

Roosevelt Stackhouse Jr., RN

Home Health Registered Nurse · Florence, SC

NPI number 1225455074 Active

Practice location

1705 W Evans St
Florence, SC 29501-3331

Fax (843) 774-1047

Mailing address

PO Box 648, 521 Gilchrist Road
Mullins, SC 29574-0648

Specialties and licenses

TaxonomyCodeLicense
Home Health Registered Nurse Primary 163WH0200X37318 (SC)

Home Health Registered Nurse: Definition to come...

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About NPI 1225455074

Roosevelt Stackhouse Jr., RN's National Provider Identifier is 1225455074, issued on Mar 18, 2014. The primary taxonomy on file is Home Health Registered Nurse (163WH0200X), and the practice location is in Florence, SC. The record was last updated on Mar 18, 2014.