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NPI Code Detail

MEDICARE: AMANDA BERGDORF PYRDA APRN

MEDICARE: AMANDA BERGDORF PYRDA APRN
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
1363LF0000XFamily Nurse Practitioner27027SC

General Provider Information

NPI Number : 1013617679
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA BERGDORF PYRDA APRN
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number : 888-472-0043
Fax Number :
Provider Business Practice Location Address
First Line : 897 VON KOLNITZ RD STE 101
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-3630
Country : US
Telephone Number : 843-534-1770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2023
Last Update Date : 05/01/2025

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Directions to “ AMANDA BERGDORF PYRDA APRN” Practice Location

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