Organization · Type 2 NPI
Provision Healthcare, LLC
Family Nurse Practitioner · Columbia, SC
NPI number
1669968152
Active
Practice location
1320 Main St Ste 300
Columbia, SC 29201-3266
Mailing address
4611 Hard Scrabble Rd Ste 178
Columbia, SC 29229-8584
Other practice locations
- 4611 Hard Scrabble Rd Ste 178, Columbia, SC 29229-8584 · (803) 373-0063
- 10120 Two Notch Rd # 133, Columbia, SC 29223-4395 · (803) 373-0063
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | BL015940-07-2018 (SC) |
Family Nurse Practitioner: Definition to come...
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About NPI 1669968152
Provision Healthcare, LLC's National Provider Identifier is 1669968152, issued on Jul 8, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Columbia, SC. The record was last updated on Jul 8, 2018.