Provider Demographics
NPI:1689174401
Name:ARNTZ, MARY V (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:V
Last Name:ARNTZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:V
Other - Last Name:ARNTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:GINGER ARNTZ FNP-C
Mailing Address - Street 1:321 E SHEPARD LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-4262
Mailing Address - Country:US
Mailing Address - Phone:843-364-1982
Mailing Address - Fax:
Practice Address - Street 1:3901 SPICEWOOD SPRINGS RD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8723
Practice Address - Country:US
Practice Address - Phone:843-364-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily