Healthcare Provider Details

I. General information

NPI: 1689464893
Provider Name (Legal Business Name): TUWANNA DENISE BRANHAM-RICHARDSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 HENDERSON ST STE B
COLUMBIA SC
29201-2648
US

IV. Provider business mailing address

105 FRANKLIN SQUARE WAY STE A
EASLEY SC
29642-3715
US

V. Phone/Fax

Practice location:
  • Phone: 803-376-1717
  • Fax: 803-376-1716
Mailing address:
  • Phone: 864-442-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number30244
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: