Individual
MS. KIMBERLY BRENTLINGER FANGUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
146 E HOSPITAL DR STE 140, WEST COLUMBIA, SC 29169-4800
(803) 936-7076
(803) 936-7925
Mailing address
1032A KINLEY RD, IRMO, SC 29063-9632
(803) 612-0830
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
20513
SC
363LF0000X
Family Nurse Practitioner
20513
SC
Other
Enumeration date
01/20/2017
Last updated
01/11/2024
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