Provider Demographics
NPI:1700291168
Name:GARRISON, AMY B (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:B
Last Name:GARRISON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:L
Other - Last Name:BOGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 743294
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3294
Mailing Address - Country:US
Mailing Address - Phone:864-295-2500
Mailing Address - Fax:864-295-2506
Practice Address - Street 1:201 EPSILON ZETA DRIVE 101 EDWARDS HALL
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-5262
Practice Address - Country:US
Practice Address - Phone:864-656-1896
Practice Address - Fax:864-656-1123
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2933Medicaid