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NPI Code Detail

MEDICARE: ANDREA LYNN SIMMONS NANCE FNP

MEDICARE:   ANDREA LYNN SIMMONS NANCE  FNP
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
1363L00000XNurse Practitioner201481NC
2363L00000XNurse Practitioner2538SC

General Provider Information

NPI Number : 1548358898
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LYNN SIMMONS NANCE FNP
Provider Business Mailing Address
First Line : PO BOX 749306
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2246 HIGHWAY 17
Second Line :
City : LITTLE RIVER
State : SC
Zip : 29566-9235
Country : US
Telephone Number : 843-663-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 11/11/2024

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Directions to “ ANDREA LYNN SIMMONS NANCE FNP” Practice Location

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