IndividualActive
Roosevelt Stackhouse, RN
NPI 1225455074 · Home Health Registered Nurse · Florence, SC
Provider details
- NPI number
- 1225455074
- Entity type
- Individual
- Primary specialty
- Home Health Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Male
- Sole proprietor
- Yes
- License
- 37318 (SC)
Specialties & taxonomies
Nursing Service Providers
Practice location
1705 W Evans St
Florence, SC 29501-3331
Phone: (843) 774-1577
Fax: (843) 774-1047
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 648
Mullins, SC 29574-0648
Registry dates
- Enumerated
- 2014-03-18
- Last updated
- 2014-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.