MEDICARE: ALBANIE NOEL RNFA

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	163WR0006X	Registered Nurse First Assistant	103230	SC

General Provider Information

NPI Number	:	1962032573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBANIE NOEL RNFA

Provider Business Mailing Address
First Line	:	1533 BARQUENTINE DR
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-4900
Country	:	US
Telephone Number	:	843-408-2384
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 N HIGHWAY 17
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29466-9123
Country	:	US
Telephone Number	:	843-884-0301
Fax Number	:

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

Provider Enumeration Date	:	01/22/2020
Last Update Date	:	01/22/2020

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