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General NPI Number Information
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NPI Number | 1669445680
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Entity Type | Individual
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Provider Name | AMANDA COLEBURN FNP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 800 E CHEVES ST SUITE 370
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City | FLORENCE
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State | SC
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Zip | 29506-2650
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Country | US
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Telephone | 843-665-2191
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Fax | 843-679-0818
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Provider Business Mailing Address
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Address Line | PO BOX 3239
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City | FLORENCE
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State | SC
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Zip | 29502-3239
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Country | US
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Telephone | 843-777-7132
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Fax | 843-777-4487
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN 826
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License Number State | SC
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