Provider Demographics
NPI:1518362524
Name:KURZYNSKE, MEGAN C (ANP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:KURZYNSKE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:C
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 GAMECOCK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3398
Mailing Address - Country:US
Mailing Address - Phone:843-769-8215
Mailing Address - Fax:843-769-8216
Practice Address - Street 1:27 GAMECOCK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3398
Practice Address - Country:US
Practice Address - Phone:843-769-8215
Practice Address - Fax:843-769-8216
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19190363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health