Healthcare Provider Details

I. General information

NPI: 1285542837
Provider Name (Legal Business Name): BRIANNA NUXOLL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 CENTRAL AVE UNIT A
SUMMERVILLE SC
29483-5587
US

IV. Provider business mailing address

4650 CRESCENT POINTE DR APT 833
NORTH CHARLESTON SC
29418-3814
US

V. Phone/Fax

Practice location:
  • Phone: 843-832-4017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH.67967
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: