Individual
MRS. AMANDA LEIGH EXUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP
Contact information
Practice address
853 N CHURCH ST STE 401, SPARTANBURG, SC 29303-3064
(864) 560-6287
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
22833
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7953
—
SC
01
—
SCL406H895
MEDICARE PIN
SC
Enumeration date
10/08/2021
Last updated
12/01/2021
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