MEDICARE: PAULA B PARNELL 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
1	363LP2300X	Primary Care Nurse Practitioner	2983	SC
2	363LF0000X	Family Nurse Practitioner	5005171	NC
3	363LF0000X	Family Nurse Practitioner	2983	SC

General Provider Information

NPI Number	:	1598871147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA B PARNELL FNP

Provider Business Mailing Address
First Line	:	2408 MADISON DR STE 102
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4328
Country	:	US
Telephone Number	:	843-892-0007
Fax Number	:	855-710-6355

Provider Business Practice Location Address
First Line	:	2408 MADISON DR STE 102
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4328
Country	:	US
Telephone Number	:	843-892-0007
Fax Number	:	855-710-6355

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	03/16/2026

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