Provider Demographics
NPI:1790088623
Name:MCNUTT, JAMES REX (ACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:REX
Last Name:MCNUTT
Suffix:
Gender:M
Credentials:ACNP-BC
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Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7042
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:401 EAST CHEVES STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2615
Practice Address - Country:US
Practice Address - Phone:843-777-7863
Practice Address - Fax:843-777-7873
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2014-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704260109363LA2100X
SC18958363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care