Individual
MS. SALLIE I PRUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR, SUITE 400, COLUMBIA, SC 29203-6877
(803) 434-7950
(803) 434-8606
Mailing address
9 MEDICAL PARK RD, SUITE 200A, COLUMBIA, SC 29203-8003
(803) 434-7950
(803) 434-8606
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN2421
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0311
—
SC
Enumeration date
07/03/2006
Last updated
12/17/2007
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