Individual
AMANDA CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11 GATEWAY CORNERS PARK, COLUMBIA, SC 29203
(803) 462-2300
(803) 462-0375
Mailing address
11 GATEWAY CORNERS PARK, COLUMBIA, SC 29203
(803) 462-2300
(803) 462-0375
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17840
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12469613
CAQH PROVIDER ID
SC
05
—
NP2176
—
SC
Enumeration date
06/12/2012
Last updated
07/29/2025
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