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General NPI Number Information
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NPI Number | 1255093068
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Entity Type | Individual
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Provider Name | AMANDA LEIGH EXUM APRN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 853 N CHURCH ST STE 401
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City | SPARTANBURG
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State | SC
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Zip | 29303-3064
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Country | US
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Telephone | 864-560-6287
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2168
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City | SPARTANBURG
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State | SC
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Zip | 29304-2168
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Country | US
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Telephone | 864-560-4304
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Fax | 864-560-4413
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 22833
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License Number State | SC
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