Organization
NURSE PRACTITIONERS OF THE CAROLINAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGIE LARISSA OVERTON NP (NURSE PRACTITIONER)
(803) 429-7716
Entity
Organization
Contact information
Practice address
10120 TWO NOTCH RD, COLUMBIA, SC 29223-4395
(803) 429-7716
Mailing address
10120 TWO NOTCH RD, COLUMBIA, SC 29223-4395
(803) 429-7716
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
19829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3664
—
SC
Enumeration date
03/21/2017
Last updated
03/21/2017
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