Provider Demographics
NPI:1861731291
Name:PYFROM, VICKIE TAYLOR (RN/BSN)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:TAYLOR
Last Name:PYFROM
Suffix:
Gender:F
Credentials:RN/BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BOMBING RANGE RD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-9659
Mailing Address - Country:US
Mailing Address - Phone:803-462-3900
Mailing Address - Fax:803-462-3901
Practice Address - Street 1:121 BOMBING RANGE RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-9659
Practice Address - Country:US
Practice Address - Phone:803-462-3900
Practice Address - Fax:803-462-3901
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR201966163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool