MRS. PRUDENCE MELINDA OLSEN (NPI# 1619228145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619228145 |
| Entity Type | Individual |
| Full Name | MRS. PRUDENCE MELINDA OLSEN |
| Credential | PA-C |
| Practice Address |
1120 Glenns Bay Rd Surfside Beach SC 29575-4757 |
| Mailing Address |
1552 Heathmuir Dr Myrtle Beach SC 29575-5370 |
| Practice Telephone | 8432155492 |
| Practice Fax Number | 8432155512 |
| Mailing Telephone | 8439951136 |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
271 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1120 GLENNS BAY RD |
| City | SURFSIDE BEACH |
| State | SC |
| Zip Code | 29575-4757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083675060 | Philip Brereton Bestic | Internal Medicine | 1120 Glenns Bay Rd, Suite 101, Surfside Beach, SC 29575-4757 | 2006-03-30 |
| 1659797157 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1120 Glenns Bay Rd, Suite 103, Surfside Beach, SC 29575-4757 | 2014-03-09 |
| 1033239678 | Peggy Yvonne Lively | Nurse Practitioner | 1120 Glenns Bay Rd, Surfside Beach, SC 29575-4757 | 2007-03-29 |
| 1851425763 | Coastal Podiatry Associates Pa | Podiatrist | 1120 Glenns Bay Rd, Suite 103, Surfside Beach, SC 29575-4757 | 2007-03-15 |
| 1649229535 | Alfred Jess Tomlinson | Ophthalmology | 1120 Glenns Bay Rd, Suite 106, Surfside Beach, SC 29575-4757 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956561 | Adam Christian | Student in an Organized Health Care Education/Training Program | 611 S Hollywood Dr., Surfside Beach, SC 29575 | 2020-06-11 |
| 1740824481 | Latasha Irene Jones | Home Health | 1180 5th Ave N Ext, Unit I, Surfside Beach, SC 29575 | 2019-11-06 |
| 1518430693 | Surfside Counseling, LLC | Counselor | 1500 North Hwy 17 Business, Suite 104, Surfside Beach, SC 29575 | 2019-01-10 |
| 1316424393 | Mobile Medical PC | Clinic/Center | 1991 Glenns Bay Rd Ste 102b, Myrtle Beach, SC 29575 | 2018-07-23 |
| 1841786845 | Eva C Yu | Acupuncturist | 1514 Us-17 Bus, Surfside Beach, SC 29575 | 2018-07-03 |
| 1295262053 | Johanna Moeller | Speech-Language Pathologist | 8703 Highway 17 Bypass S, Suite I, Myrtle Beach, SC 29575 | 2017-05-11 |
| 1104227560 | Office Align Incorporated | Chiropractor | 8733 Bypass 17, Surfside Beach, SC 29575 | 2014-09-04 |
| 1972923738 | Walmart | Pharmacy | 125 Maryport Drive, Myrtle Beach, SC 29575 | 2014-04-21 |
| 1164719472 | South Beach Dental Office Inc. | Dentist | 8848 Hwy 17 Bypass, Surfside Beach, SC 29575 | 2011-07-07 |
| 1083943815 | Prs II, LLC | Physical Therapist | 3076 Dick Pond Road Unit 4, Myrtle Beach, SC 29575 | 2009-12-07 |
| Find all providers in zip 29575 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447278569 | Gwendolyn G Strickland | Physician Assistant | 1600 Highway 17 N, Surfside Beach, SC 29575-6015 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639712482 | Brianna Julia Starr | Physician Assistant | 1403 E Greenville St Ste B, Anderson, SC 29621-2285 | 2019-10-24 |
| 1255974655 | Kaitlyn T Brown | Physician Assistant | 808 Farrar Drive, Conway, SC 29526-8747 | 2019-10-18 |
| 1053960914 | Chad Waddell | Physician Assistant | 107 Walnut Ln, North Augusta, SC 29860-8629 | 2019-09-04 |
| 1508429317 | Charlotte H. Hanna | Physician Assistant | 800 E Cheves St Ste 380, Florence, SC 29506-2649 | 2019-04-17 |
| 1407342116 | Thrive Essential Wellness, Inc. | Physician Assistant | 1511 9th Ave Ste A, Conway, SC 29526-4126 | 2018-07-05 |
| 1700392495 | Stephanie Meyer | Physician Assistant | 5 Medical Park Road Palmetto Health, Columbia, SC 29203 | 2017-12-18 |
| 1073022612 | Gina Marie Sanitato | Physician Assistant | 1300 Hospital Dr Ste 300, Mt Pleasant, SC 29464-3217 | 2017-09-27 |
| 1659896264 | Morgan N Warthan | Physician Assistant | Gateway Family Medicine, 406 N Poinsett Hwy, Travelers Rest, SC 29690-1667 | 2017-08-04 |
| 1366994824 | Colonial Family Practice, LLC | Physician Assistant | 3750 Savannah Hwy Ste I, Johns Island, SC 29455-7909 | 2016-11-01 |
| 1457804080 | Mcleod Physician Associates II | Physician Assistant | 945 82nd Pkwy Ste 3, Myrtle Beach, SC 29572-4612 | 2016-08-01 |
| Find all providers with the same taxonomy | ||||
| City | SURFSIDE BEACH |
| Zip Code | 29575 |
Please comment or provide details below to improve the information on MRS. PRUDENCE MELINDA OLSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.