Green, Amanda U.

Green, Amanda U. is an individual health care provider with primary practice located at 1064 Gardner Rd Ste 105-106 , Charleston SC 29407-5768. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Green, Amanda U. can be contacted via phone (854) 429-1175.

Contact Information

Primary practice address
1064 Gardner Rd Ste 105-106 Charleston SC 29407-5768
Phone: (854) 429-1175
Fax: (843) 685-9467
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X 217075 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 22248 South Carolina

Profile Details

NPI number 1174939219
LBN Legal business name Green, Amanda U.
Credentials DNP,FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2014
Last updated Oct 14th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174939219 NPPES
South Carolina Other SC2315A634 MEDICARE PTAN
South Carolina MEDICAID NP5922 MEDICARE PTAN

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