Provider Demographics
NPI:1730551532
Name:WALDROP, NAOMI RUTH (RN)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:RUTH
Last Name:WALDROP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:
Other - Last Name:WALDROP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:355 CEDAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-4628
Mailing Address - Country:US
Mailing Address - Phone:864-577-7780
Mailing Address - Fax:864-577-7629
Practice Address - Street 1:355 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-4628
Practice Address - Country:US
Practice Address - Phone:864-577-7780
Practice Address - Fax:864-577-7629
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201911163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse