Provider Demographics
NPI:1275680704
Name:GRZECH, JAMES A (FNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:GRZECH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5221
Mailing Address - Country:US
Mailing Address - Phone:843-667-9947
Mailing Address - Fax:843-667-0455
Practice Address - Street 1:500 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5221
Practice Address - Country:US
Practice Address - Phone:843-667-9947
Practice Address - Fax:843-667-0455
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRX2770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ611608712Medicare UPIN