Prugh, Sallie I

Prugh, Sallie I is an individual health care provider with primary practice located at 14 Richland Medical Park Dr Suite 400, Columbia SC 29203-6877. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Prugh, Sallie I can be contacted via phone (803) 434-7950.

Contact Information

Primary practice address
14 Richland Medical Park Dr Suite 400 Columbia SC 29203-6877
Fax: (803) 434-8606
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APN2421 South Carolina

Profile Details

NPI number 1720017395
LBN Legal business name Prugh, Sallie I
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Dec 17th, 2007 - about 17 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 1720017395 NPPES
South Carolina MEDICAID NP0311

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