Provider Demographics
NPI:1538514351
Name:TAPP, FELICIA (NP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:TAPP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-7779
Practice Address - Street 1:1200 E MAIN ST
Practice Address - Street 2:SUITE 12
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1711
Practice Address - Country:US
Practice Address - Phone:864-560-9260
Practice Address - Fax:864-560-9265
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC8288J577OtherMEDICARE PIN
SCNP3848Medicaid
SCSC82886121OtherMEDICARE PIN
SCSC82883365OtherMEDICARE PIN
SCSC82886067OtherMEDIARE PIN
SCNP3848Medicaid