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NPI Code Detail

MEDICARE: MRS. SARAH MANGLICMOT CAMPOS O'NEILL APRN

MEDICARE:  MRS. SARAH MANGLICMOT CAMPOS O'NEILL  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
1363LP2300XPrimary Care Nurse Practitioner21323SC
2363LF0000XFamily Nurse Practitioner21323SC

General Provider Information

NPI Number : 1528569712
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARAH MANGLICMOT CAMPOS O'NEILL APRN
Provider Business Mailing Address
First Line : 2411 N OAK ST
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-3173
Country : US
Telephone Number : 843-670-6943
Fax Number : 843-791-0899
Provider Business Practice Location Address
First Line : 2411 N OAK ST
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-3173
Country : US
Telephone Number : 843-670-6943
Fax Number : 843-791-0899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2018
Last Update Date : 03/31/2026

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Directions to “ MRS. SARAH MANGLICMOT CAMPOS O'NEILL APRN” Practice Location

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