Healthcare Provider Details

I. General information

NPI: 1063554277
Provider Name (Legal Business Name): NANCY E HELLENGA RNC, GONP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST SUITE 4500
ANDERSON SC
29621-1580
US

IV. Provider business mailing address

PO BOX 2047
ANDERSON SC
29622-2047
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-4500
  • Fax: 864-512-4505
Mailing address:
  • Phone: 864-512-4500
  • Fax: 864-512-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPN 489
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: