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NPI Code Detail

MEDICARE: LAUREN MARIE MIANULLI FNP

MEDICARE: LAUREN MARIE MIANULLI 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 Practitioner31147SC

General Provider Information

NPI Number : 1750789541
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN MARIE MIANULLI FNP
Provider Business Mailing Address
First Line : 171 ASHLEY AVE
Second Line :
City : CHARLESTON
State : SC
Zip : 29425-0100
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 171 ASHLEY AVE
Second Line :
City : CHARLESTON
State : SC
Zip : 29425-0100
Country : US
Telephone Number : 843-876-5026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2014
Last Update Date : 02/04/2026

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Directions to “ LAUREN MARIE MIANULLI FNP” Practice Location

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