PRUNETTA BRUNSON NPI 1538662556

NPI Information

NPI: 1538662556
Provider Name: PRUNETTA BRUNSON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: APOGEE MEDICAL GROUP SOUTH CAROLINA

PECOS Registration: Yes

Address:
2435 FOREST DR
COLUMBIA, SC
ZIP 29204
Phone: (803) 256-5855
Get Directions

Prunetta Brunson is a family nurse practitioner in Columbia, SC with 7 years of experience. Prunetta Brunson NPI is 1538662556. 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:

2435 FOREST DR
COLUMBIA, SC
ZIP 29204-026
Phone: (803) 256-5855
Fax: (803) 400-5089

The NPI 1538662556 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/15/2018 and was last updated on 6/17/2021.

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	363L00000X	Nurse Practitioner		21737	SOUTH CAROLINA	No
2	363LF0000X	Nurse Practitioner	Family	21737	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	Other Provider Identifier Issuer
1	NP5114	MEDICAID	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: 11/14/2023

NPI Synchronization or Removal

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