IndividualActive
Bonita Spade, FNP,CDE
NPI 1861569329 · Adult Health Nurse Practitioner · North Charleston, SC
Provider details
- NPI number
- 1861569329
- Entity type
- Individual
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP,CDE
- Sex
- Female
- Sole proprietor
- No
- License
- R64665 (SC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2845 Tricom St
North Charleston, SC 29406-9172
Phone: (843) 797-1770
Fax: (843) 553-1498
Approximate (ZIP-level) locationGet directions
Mailing address
2845 Tricom St
North Charleston, SC 29406-9172
Registry dates
- Enumerated
- 2006-11-29
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.