Individual
AMY FURMANSKI BALLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
(803) 461-3000
Mailing address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
(803) 461-3000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
17733
SC
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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