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NPI Code Detail

MEDICARE: MRS. LYNDA MICHELLE AVERA APRN

MEDICARE:  MRS. LYNDA MICHELLE AVERA  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner22458SC

General Provider Information

NPI Number : 1619522323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNDA MICHELLE AVERA APRN
Provider Business Mailing Address
First Line : 1300 HOSPITAL DR STE 150
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3243
Country : US
Telephone Number : 843-375-2210
Fax Number : 843-375-2214
Provider Business Practice Location Address
First Line : 1300 HOSPITAL DR STE 150
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3243
Country : US
Telephone Number : 843-375-2210
Fax Number : 843-375-2214
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2019
Last Update Date : 08/08/2019

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Directions to “ MRS. LYNDA MICHELLE AVERA APRN” Practice Location

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