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NPI Code Detail

MEDICARE: MRS. CHERYL LAVERNE SUBER PMHNP

MEDICARE: MRS. CHERYL LAVERNE SUBER PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner3188SC
2363LF0000XFamily Nurse Practitioner3188SC

General Provider Information

NPI Number : 1245451269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL LAVERNE SUBER PMHNP
Provider Business Mailing Address
First Line : 220 BROOKSDALE DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-8415
Country : US
Telephone Number : 803-446-3830
Fax Number :
Provider Business Practice Location Address
First Line : 115 ATRIUM WAY STE 221
Second Line :
City : COLUMBIA
State : SC
Zip : 29223-6383
Country : US
Telephone Number : 843-501-1099
Fax Number : 803-699-8824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/11/2023

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