Ingrid Patricia Pearson, MS RN CPNP

Individual provider Active NPI Pediatric Nurse Practitioner · Batesburg, SC

NPI 1407945355 · NPPES record last updated Mar 7, 2011

Key facts

NPI
1407945355
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
1003 (SC)
Practice address
120 W Church St
Batesburg, SC 29006-2107
Phone
(803) 532-2208
Fax
(803) 604-0207
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Pediatric Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1003SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1003 SC Yes

Addresses

Primary practice location

120 W Church St
Batesburg, SC 29006-2107

Mailing address

120 W Church St
Batesburg-Leesville, SC 29006-2107
Phone (803) 532-2208

Other identifiers

IdentifierTypeStateIssuer
NP0181MedicaidSC

Other providers in Batesburg, SC

All providers in Batesburg, SC · Pediatric Nurse Practitioner in South Carolina

Sources for this page

Verify at the official NPI Registry.