Individual
VITALIY V. PIPENKO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1809 WADE HAMPTON BLVD STE 120, GREENVILLE, SC 29609-4050
(864) 522-5000
(864) 241-9275
Mailing address
1 INDEPENDENCE PT, STE 212, GREENVILLE, SC 29615-4545
(864) 797-6306
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
19427
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3351
—
SC
Enumeration date
05/17/2015
Last updated
06/10/2021
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