MEDICARE: KATHRYN SARAH SZCZECHOWSKI DNP, RN, AGACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	4704342714	MI
2	363LA2100X	Acute Care Nurse Practitioner	APN.29387	SC
3	163W00000X	Registered Nurse	4704342714	MI
4	363LA2200X	Adult Health Nurse Practitioner	4704342714	MI

General Provider Information

NPI Number	:	1972221190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN SARAH SZCZECHOWSKI DNP, RN, AGACNP-BC

Provider Business Mailing Address
First Line	:	30 COURTENAY DRIVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-6712
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

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

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	01/02/2026

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