Individual
MS. AMY JEANETTE DIEVENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1655 BERNARDIN AVENUE, SUITE - 350, COLUMBIA, SC 29204
(803) 253-7575
(803) 253-7571
Mailing address
330 SEVEN SPRINGS WAY, SUITE - 425, BRENTWOOD, TN 37027-5098
(615) 920-7878
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4341SC
SC
Other
Enumeration date
09/28/2010
Last updated
01/19/2017
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