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General NPI Number Information
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NPI Number | 1578312336
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Entity Type | Individual
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Provider Name | MADISON BRINDLE
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Gender | Female
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 2600 BULL ST
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City | COLUMBIA
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State | SC
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Zip | 29201-1708
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Country | US
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Telephone | 843-412-4407
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 NANTAHALA BLVD
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-9751
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Country | US
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Telephone | 585-298-0453
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Fax |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 275462
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License Number State | SC
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