Healthcare Provider Details

I. General information

NPI: 1669806493
Provider Name (Legal Business Name): ASHLEY ROBINSON MUNN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 CLEMSON RD
COLUMBIA SC
29229-7925
US

IV. Provider business mailing address

460 CLEMSON RD
COLUMBIA SC
29229-7925
US

V. Phone/Fax

Practice location:
  • Phone: 803-438-3800
  • Fax: 803-438-3898
Mailing address:
  • Phone: 803-438-3800
  • Fax: 803-438-3898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN 18460
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: