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NPI Code Detail

MEDICARE: MS. SUSAN VIGEANT APRN

MEDICARE: MS. SUSAN VIGEANT 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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse SpecialistAPN1561SC

General Provider Information

NPI Number : 1861492092
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN VIGEANT APRN
Provider Business Mailing Address
First Line : PO BOX 68
Second Line :
City : ROCK HILL
State : SC
Zip : 29731-6068
Country : US
Telephone Number : 803-327-6103
Fax Number : 803-328-5443
Provider Business Practice Location Address
First Line : 2400 W MAIN ST
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-8968
Country : US
Telephone Number : 803-327-6103
Fax Number : 803-328-5443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 11/06/2008

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