NICOLE KONDA FNP NPI 1558608067

NPI Information

NPI: 1558608067
Provider Name: NICOLE KONDA, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
701 GROVE RD FL 5
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-4411
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Nicole Konda, FNP is a family nurse practitioner in Greenville, SC with 12 years of experience. Nicole Konda, FNP NPI is 1558608067. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

701 GROVE RD FL 5
GREENVILLE, SC
ZIP 29605-210
Phone: (864) 455-4411
Fax: (864) 455-4480

The NPI 1558608067 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/4/2013 and was last updated on 3/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		CP001709	SOUTH DAKOTA	No
2	363LF0000X	Nurse Practitioner	Family	2013000129	MISSOURI	No
3	363LF0000X	Nurse Practitioner	Family	26862	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP9596	MEDICAID	SOUTH CAROLINA
2	1558608067	MEDICAID	MISSOURI
3	431560263	OTHER	MISSOURI	TRICARE
4	P01160135	OTHER	MISSOURI	RR MCR
5	196346758	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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