Individual
MRS. AMANDA KORNEGAY MARULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2580 WOODRUFF RD, SIMPSONVILLE, SC 29681-5447
(864) 627-7228
Mailing address
2580 WOODRUFF RD, SIMPSONVILLE, SC 29681-5447
(864) 627-7228
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17550
SC
Other
Enumeration date
07/31/2011
Last updated
07/31/2011
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