Healthcare Provider Details

I. General information

NPI: 1699858837
Provider Name (Legal Business Name): LAURA MARIE GARNETT APRN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/03/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 KNOX AVE
NORTH AUGUSTA SC
29841-4010
US

IV. Provider business mailing address

PO BOX 749306
ATLANTA GA
30374-9306
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-4120
  • Fax: 803-279-5418
Mailing address:
  • Phone: 803-279-4120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1127
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN100396NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: