Individual
MS. AMANDA GRACE BEVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
105 VINECREST CT # 1000, GREENWOOD, SC 29646-8031
(864) 725-3350
(864) 725-3351
Mailing address
1601 GREENE ST, COLUMBIA, SC 29208-4001
(803) 777-7412
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
28004
SC
Other
Enumeration date
01/23/2023
Last updated
08/01/2024
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