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General NPI Number Information
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NPI Number | 1699722884
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Entity Type | Individual
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Provider Name | SANDRA MARION BREMNER FNP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 8014 MYRTLE TRACE DR
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City | CONWAY
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State | SC
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Zip | 29526
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Country | US
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Telephone | 843-997-0912
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Fax | 888-979-8571
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Provider Business Mailing Address
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Address Line | 137 HOLCOMBE LN
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City | CONWAY
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State | SC
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Zip | 29527-8616
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Country | US
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Telephone | 843-997-0912
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Fax | 888-979-8571
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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 | 1956
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License Number State | SC
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