Healthcare Provider Details

I. General information

NPI: 1477784833
Provider Name (Legal Business Name): CARRIE POWERS ZIPPERER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 GRACES WAY
COLUMBIA SC
29229-1613
US

IV. Provider business mailing address

8 FARMFIELD AVE STE D
CHARLESTON SC
29407-7779
US

V. Phone/Fax

Practice location:
  • Phone: 803-736-4560
  • Fax: 803-744-1217
Mailing address:
  • Phone: 803-736-4560
  • Fax: 803-744-1217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: