MS. SALLIE I PRUGH CPNP NPI 1720017395

NPI Information

NPI: 1720017395
Provider Name: MS. SALLIE I PRUGH, CPNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
14 RICHLAND MEDICAL PARK DR
SUITE 400
COLUMBIA, SC
ZIP 29203
Phone: (803) 434-7950
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MS. Sallie I Prugh, CPNP is a pediatrics nurse practitioner in Columbia, SC. MS. Sallie I Prugh, CPNP NPI is 1720017395. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14 RICHLAND MEDICAL PARK DR
SUITE 400
COLUMBIA, SC
ZIP 29203-877
Phone: (803) 434-7950
Fax: (803) 434-8606

The enumeration date for this NPI number is 7/3/2006 and was last updated on 12/17/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	APN2421	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	NP0311	MEDICAID	SOUTH CAROLINA
2	P08151	MEDICARE UPIN
3	P08151	MEDICARE PIN	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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