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NPI Code Detail

MEDICARE: ELIZABETH J. REPEDE NP

MEDICARE:   ELIZABETH J. REPEDE  NP
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 Practitioner812SC
2363LF0000XFamily Nurse Practitioner5004384NC

General Provider Information

NPI Number : 1275596306
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH J. REPEDE NP
Provider Business Mailing Address
First Line : 7075 HARBOR CT
Second Line :
City : TEGA CAY
State : SC
Zip : 29708-8534
Country : US
Telephone Number : 802-517-0302
Fax Number : 803-802-3420
Provider Business Practice Location Address
First Line : 7075 HARBOR CT
Second Line :
City : TEGA CAY
State : SC
Zip : 29708-8534
Country : US
Telephone Number : 802-517-0302
Fax Number : 803-802-3420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 05/20/2009

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