Provider Demographics
NPI:1780217513
Name:POTHEN, ABIGAIL DREW (WHNP, APRN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:DREW
Last Name:POTHEN
Suffix:
Gender:F
Credentials:WHNP, APRN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:DREW
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:1301 TAYLOR ST STE 1A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2946
Practice Address - Country:US
Practice Address - Phone:803-434-4790
Practice Address - Fax:803-434-4799
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231880363L00000X, 363LW0102X
SC27410363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner