Provider Demographics
NPI:1740243252
Name:GIOVANNETTI, MARY CHRISTINA (NP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CHRISTINA
Last Name:GIOVANNETTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:913 PALMDALE CT
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-6149
Mailing Address - Country:US
Mailing Address - Phone:864-578-1365
Mailing Address - Fax:
Practice Address - Street 1:853 N CHURCH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3098
Practice Address - Country:US
Practice Address - Phone:864-560-6192
Practice Address - Fax:864-560-6509
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCF1535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCS83514Medicare UPIN