Elizabeth J. Repede, NP
Individual provider Active NPI Family Nurse Practitioner · Tega Cay, SC
NPI 1275596306 · NPPES record last updated May 20, 2009
Key facts
- NPI
- 1275596306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5004384 (NC)
- Practice address
- 7075 Harbor CT
Tega Cay, SC 29708-8534 - Phone
- (802) 517-0302
- Fax
- (803) 802-3420
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 812 | SC | MD | Mental Health Counselor |
| 5004384 | NC | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 812 | SC | |
| Family Nurse Practitioner | 363LF0000X | 5004384 | NC | Yes |
Addresses
Primary practice location
7075 Harbor CT
Tega Cay, SC 29708-8534
Mailing address
7075 Harbor CT
Tega Cay, SC 29708-8534
Phone (802) 517-0302
Other providers in Tega Cay, SC
- Faith Plemmons
- Pamela Pompey
- Shannon Powers-Jones
- Alexis Reale
- Melissa Marie Reinking
- Allyssa Resech
- Cynthia Elizabeth Royston
- Sager Consulting
- Lauren Scamacca
- Theresa Jane Schaedig
All providers in Tega Cay, SC · Family Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.