| Amanda Mallory, NP | |
|
1847 S Lake Dr, Lexington, SC 29073-7759 | |
| (803) 356-8998 | |
| Not Available |
| Full Name | Amanda Mallory |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 1847 S Lake Dr, Lexington, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689116055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 20586 (South Carolina) | Primary |
| Entity Name | Nisha Jackson Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124499124 PECOS PAC ID: 6305147745 Enrollment ID: O20151209000878 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Mallory, NP 703 Dawsons Park Way, Lexington, SC 29072-1906 Ph: (038) 240-9995 | Amanda Mallory, NP 1847 S Lake Dr, Lexington, SC 29073-7759 Ph: (803) 356-8998 |
Victoria Fenters, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1316 N Lake Dr, Lexington, SC 29072 Phone: 803-358-1191 | |
Dr. Brooke Patterson, DNP, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 815 Old Cherokee Rd, Lexington, SC 29072 Phone: 803-359-5181 | |
Mrs. Carolyn Birchmore, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1316 N Lake Dr, Lexington, SC 29072 Phone: 803-358-1191 Fax: 803-358-1180 | |
Amy Loper, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 811 W Main St Ste 207, Lexington, SC 29072 Phone: 803-358-6420 | |
Donna Marie Bridger, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2480 Two Notch Rd, Lexington, SC 29072 Phone: 803-951-5871 Fax: 803-951-5882 | |
Emilee Rikard Campbell, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 811 W Main St Ste 201&209, Lexington, SC 29072 Phone: 803-785-4777 Fax: 803-358-6240 | |
Lisa Lynn Livingston, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1633 S Lake Dr, Lexington, SC 29073 Phone: 803-520-9380 Fax: 803-520-5972 |