=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811302946
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PIA V BIASON-WEBB FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2014
-----------------------------------------------------
Last Update Date | 06/27/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 MIDTOWN DR
-----------------------------------------------------
City | BEAUFORT
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29906-5200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-379-7746
-----------------------------------------------------
Fax | 843-521-1275
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 670
-----------------------------------------------------
City | PORT ROYAL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29935-0670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-379-7746
-----------------------------------------------------
Fax | 843-521-1275
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 18873
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------