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Individual

AMANDA BULLOCK KANIPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
3980 HIGHWAY 9 E STE 100, LITTLE RIVER, SC 29566-8163
(843) 390-8320
(843) 366-3839
Mailing address
3980 HIGHWAY 9 E STE 100, LITTLE RIVER, SC 29566-8163
(843) 390-8320
(843) 366-3839

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
209719
NC
207Q00000X
Family Medicine Physician
27344A
SC
363LF0000X
Family Nurse Practitioner
Primary
KANI-77YRY
NC

Other

Enumeration date
04/09/2022
Last updated
09/07/2023
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