Individual
LARENZO A CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
9330 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9104
(843) 876-7080
Mailing address
314 WOODGATE WAY, SUMMERVILLE, SC 29485-7481
(843) 860-9127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
29350
SC
Other
Enumeration date
11/12/2024
Last updated
11/26/2024
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