Healthcare Provider Details

I. General information

NPI: 1033280383
Provider Name (Legal Business Name): GAYLE BENSON MESSER NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MEDICAL PARK DRIVE PALMETTO RICHLAND MEMORIAL HOSPITAL NEONATAL INTENSIVE
COLUMBIA SC
29203
US

IV. Provider business mailing address

5212 ENFIELD DRIVE
COLUMBIA SC
29212-3613
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-7151
  • Fax: 803-434-6401
Mailing address:
  • Phone: 803-772-7755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAPRN674
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: