Individual
MRS. STACY MICHELLE FENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
905 VERDAE BLVD STE 101, GREENVILLE, SC 29607-4098
(864) 286-7550
(864) 286-7550
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4134
SC
363LF0000X
Family Nurse Practitioner
Primary
4134
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1569
—
SC
Enumeration date
02/15/2010
Last updated
03/07/2023
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