IndividualActive
Alicia Pendergrass, FNP
NPI 1063883767 · Family Nurse Practitioner · Irmo, SC
Provider details
- NPI number
- 1063883767
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- License
- 19686 (SC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1 Wellness Blvd Ste 203
Irmo, SC 29063-2873
Phone: (803) 749-9920
Fax: (803) 749-9916
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 6069
West Columbia, SC 29171-6069
Additional practice locations (1)
- 811 W Main St Ste 201&209Lexington, SC 29072-2507Phone: (803) 785-4777Fax: (803) 358-6240
Registry dates
- Enumerated
- 2015-10-07
- Last updated
- 2025-08-18
- Certified
- 2025-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.