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NPI Code Detail

MEDICARE: STEPHEN FLOYD SIZEMORE FNP-BC

MEDICARE: STEPHEN FLOYD SIZEMORE FNP-BC
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
1163W00000XRegistered Nurse1121707KY
2363LF0000XFamily Nurse Practitioner3010212KY

General Provider Information

NPI Number : 1700305190
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN FLOYD SIZEMORE FNP-BC
Provider Business Mailing Address
First Line : 501 GARY HILL RD
Second Line :
City : EDGEFIELD
State : SC
Zip : 29824-4503
Country : US
Telephone Number : 803-637-1500
Fax Number :
Provider Business Practice Location Address
First Line : 501 GARY HILL RD
Second Line :
City : EDGEFIELD
State : SC
Zip : 29824-4503
Country : US
Telephone Number : 803-637-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2017
Last Update Date : 09/17/2017

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