Provider Demographics
NPI:1417958513
Name:CARDENAS, MARIA ELIZABET (CNP ANP NP)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ELIZABET
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:CNP ANP NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29457-0365
Mailing Address - Country:US
Mailing Address - Phone:803-329-6648
Mailing Address - Fax:803-985-4134
Practice Address - Street 1:1236 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2300
Practice Address - Country:US
Practice Address - Phone:803-329-6648
Practice Address - Fax:803-985-4134
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0673/GP2323Medicaid
SC7225Medicare ID - Type Unspecified
P83322Medicare UPIN