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NPI Code Detail

MEDICARE: MR. RICHARD DALE BRINSON MSN, APRN, NP-C

MEDICARE: MR. RICHARD DALE BRINSON MSN, APRN, NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner18671SC
2363LC0200XCritical Care Medicine Nurse Practitioner18671SC
3363LF0000XFamily Nurse Practitioner18671SC

General Provider Information

NPI Number : 1003230780
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD DALE BRINSON MSN, APRN, NP-C
Provider Business Mailing Address
First Line : 1802 CANAL DR
Second Line :
City : MONCKS CORNER
State : SC
Zip : 29461-9227
Country : US
Telephone Number : 843-934-9816
Fax Number :
Provider Business Practice Location Address
First Line : 9330 MEDICAL PLAZA DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9104
Country : US
Telephone Number : 843-847-4595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2014
Last Update Date : 03/06/2014

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