1285826347 NPI number — MS. SHARON LANE HOLCOMBE MS APRN-BC

Table of content: MS. SHARON LANE HOLCOMBE MS APRN-BC (NPI 1285826347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285826347 NPI number — MS. SHARON LANE HOLCOMBE MS APRN-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLCOMBE
Provider First Name:
SHARON
Provider Middle Name:
LANE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS APRN-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285826347
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 E GREENVILLE ST
Provider Second Line Business Mailing Address:
SUITE 3850
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29621-1580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-716-6024
Provider Business Mailing Address Fax Number:
864-716-6116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 E GREENVILLE ST
Provider Second Line Business Practice Location Address:
SUITE 3850
Provider Business Practice Location Address City Name:
ANDERSON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29621-1580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-716-6024
Provider Business Practice Location Address Fax Number:
864-716-6116
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1716 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1716 . This is a "SC LICENSE" identifier . This identifiers is of the category "OTHER".
  • Identifier: NP1142 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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