Scruggs, Lisa Marie

Scruggs, Lisa Marie is an individual health care provider with primary practice located at 809 82Nd Pkwy Myrtle Beach, Myrtle Beach SC 29572. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Scruggs, Lisa Marie can be contacted via phone (843) 692-1750.

Contact Information

Primary practice address
809 82Nd Pkwy Myrtle Beach Myrtle Beach SC 29572
Phone: (843) 692-1750
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 063793 North Carolina

Profile Details

NPI number 1396728242
LBN Legal business name Scruggs, Lisa Marie
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Sep 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396728242 NPPES
North Carolina MEDICAID 8050734

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