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Twanda Denise Addison

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4010 North Main Street,, Suite 2 Oasis Physical Medicine, Columbia, SC 29203

PECOS Enrollment

This provider is enrolled in PECOS as TWANDA ADDISON.

Based on the most recent information from CMS, provider Twanda Denise Addison is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1699004333
Provider Type
Individual
Full Name
Addison, Twanda Denise
Title
Ms.
Credential
APRN-BC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/9/2009
Last Updated
7/30/2010

Contact Information

Practice Location

4010 North Main Street,, Suite 2 Oasis Physical Medicine, Columbia, SC 29203

(803) 786-0559

Unlisted Fax

Mailing Location

307 Melstone Dr, Hopkins, SC 29061-8363

(803) 695-0905

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 3897 South Carolina

Twanda Denise Addison

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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