| Amanda Dudley, APRN | |
|
1 Wellness Blvd Ste 109, Irmo, SC 29063-2872 | |
| (803) 749-1111 | |
| (803) 749-0050 |
| Full Name | Amanda Dudley |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 1 Wellness Blvd Ste 109, Irmo, South Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023764081 | NPI | - | NPPES |
| 25977 | Other | SC | SC APRN LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 215127 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Prisma Health Baptist Parkridge | Columbia, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Carolina Internal Medicine Associates And Rehabilitation,l.l.c. | 1759362072 | 26 |
| Entity Name | South Carolina Internal Medicine Associates And Rehabilitation,l.l.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760483382 PECOS PAC ID: 1759362072 Enrollment ID: O20040525000145 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Dudley, APRN 7182 Woodrow St Ste 200, Irmo, SC 29063-2958 Ph: (803) 749-1111 | Amanda Dudley, APRN 1 Wellness Blvd Ste 109, Irmo, SC 29063-2872 Ph: (803) 749-1111 |
Alicia Pendergrass, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Wellness Blvd Ste 203, Irmo, SC 29063 Phone: 803-749-9920 Fax: 803-749-9916 | |
Erin Faulkenberry Siciliano, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7182 Woodrow St Ste 200, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Ms. Louise C. Holmes, MN,RN, CANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7430 College St, Irmo, SC 29063 Phone: 803-732-4001 Fax: 803-732-2123 | |
Mrs. Stefanie Lee Gunn, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7182 Woodrow St Ste 200, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Mrs. Rachel Strange, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7182 Woodrow St Ste 200, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Janeen Jensen Wood, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1008 Lake Murray Blvd, Irmo, SC 29063 Phone: 803-749-3840 |