Healthcare Provider Details

I. General information

NPI: 1588003990
Provider Name (Legal Business Name): AMY CAROLINE FRELICHE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 RUTLEDGE AVE MSC 550
CHARLESTON SC
29425-5500
US

IV. Provider business mailing address

135 RUTLEDGE AVE MSC 550
CHARLESTON SC
29425-5500
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-8733
  • Fax: 843-792-0546
Mailing address:
  • Phone: 843-792-7165
  • Fax: 843-792-0546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9380625
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18217
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: