Organization · Type 2 NPI

Prisma Health University Medical Group

Nurse Practitioner · Greenville, SC

NPI number 1053786483 Active

Practice location

712 Grove Rd
Greenville, SC 29605-4211

Fax (864) 522-1428

Mailing address

300 E Mcbee Ave Fl 4
Greenville, SC 29601-2842

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNone listed
Adult Health Nurse Practitioner 363LA2200XNone listed
Family Nurse Practitioner 363LF0000XNone listed
Gerontology Nurse Practitioner 363LG0600XNone listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1053786483

Prisma Health University Medical Group's National Provider Identifier is 1053786483, issued on Dec 10, 2015. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Greenville, SC. The record was last updated on Jun 24, 2025.