MEDICARE: INYENE SUNDAY AMOS

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
1	363L00000X	Nurse Practitioner	26731	SC

General Provider Information

NPI Number	:	1275268856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INYENE SUNDAY AMOS

Provider Business Mailing Address
First Line	:	PO BOX 23321
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-3321
Country	:	US
Telephone Number	:	843-792-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 EAST US 76
Second Line	:
City	:	MULLINS
State	:	SC
Zip	:	29574
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	11/28/2022

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