Healthcare Provider Details

I. General information

NPI: 1750965489
Provider Name (Legal Business Name): MANDY MARIE STRICKLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BUCKWALTER PLACE BLVD STE 2100
BLUFFTON SC
29910-5150
US

IV. Provider business mailing address

PO BOX 604411
CHARLOTTE NC
28260-4411
US

V. Phone/Fax

Practice location:
  • Phone: 854-278-2760
  • Fax: 854-278-2765
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25830
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: