Healthcare Provider Details

I. General information

NPI: 1639514524
Provider Name (Legal Business Name): AMY FINGAR GRAVES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 THOMASINA MCPHERSON BLVD
NORTH CHARLESTON SC
29405-8283
US

IV. Provider business mailing address

3180 THOMASINA MCPHERSON BLVD
NORTH CHARLESTON SC
29405-8283
US

V. Phone/Fax

Practice location:
  • Phone: 843-745-2174
  • Fax: 843-745-2182
Mailing address:
  • Phone: 843-745-2174
  • Fax: 843-745-2182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number43956
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: