Healthcare Provider Details

I. General information

NPI: 1528428448
Provider Name (Legal Business Name): MARY FRANCES SNIPES MSN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 SUNSET BLVD STE 300
WEST COLUMBIA SC
29169-4815
US

IV. Provider business mailing address

PO BOX 743904
ATLANTA GA
30374-3904
US

V. Phone/Fax

Practice location:
  • Phone: 803-744-4900
  • Fax:
Mailing address:
  • Phone: 803-296-7320
  • Fax: 803-293-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number20046
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number20046
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: