Provider Demographics
NPI:1295922433
Name:TREPICCIONE, AUDREY ANNE (CPM, LM)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:ANNE
Last Name:TREPICCIONE
Suffix:
Gender:
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-5025
Mailing Address - Country:US
Mailing Address - Phone:919-345-6881
Mailing Address - Fax:919-773-3523
Practice Address - Street 1:4001 POINSETT ST
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-5025
Practice Address - Country:US
Practice Address - Phone:843-274-6304
Practice Address - Fax:843-419-8818
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLMW-0088176B00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife