Individual
AMANDA C IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1200 VILLAGE HARBOR DR, LAKE WYLIE, SC 29710-9092
(803) 631-2858
(803) 631-2862
Mailing address
1200 VILLAGE HARBOR DR, LAKE WYLIE, SC 29710-9092
(803) 631-2858
(803) 631-2862
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19257
SC
363LF0000X
Family Nurse Practitioner
5008474
NC
Other
Enumeration date
04/16/2015
Last updated
04/14/2016
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