NPI 1962260232 · live from the CMS NPI Registry
360 Chronic Care Management
Nurse Practitioner in Aiken, SC. National Provider Identifier 1962260232, active.
NPI record
| NPI | 1962260232 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 35 Varden Dr Ste A-1, Aiken, SC 29803 |
| Practice phone | 803-243-1066 |
| Enumerated | March 11, 2024 |
| Last updated | June 24, 2025 |
| Authorized official | Juanethea Bryantlord, Business Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Case Management | 163WC0400X | — |
| Licensed Practical Nurse | 164W00000X | — |
| Registered Nurse, General Practice | 163WG0000X | — |
| Registered Nurse, Gerontology | 163WG0600X | — |
| Registered Nurse, Nutrition Support | 163WN1003X | — |
| Health & Wellness Coach | 171400000X | — |
| Family Medicine, Hospice and Palliative Medicine | 207QH0002X | — |
| Internal Medicine, Hospice and Palliative Medicine | 207RH0002X | — |
| Massage Therapist | 225700000X | — |
| Nurse Practitioner, Adult Health | 363LA2200X | — |
| Nurse Practitioner, Community Health | 363LC1500X | — |
| Nurse Practitioner, Gerontology | 363LG0600X | — |
| Nurse Practitioner, Primary Care | 363LP2300X | — |
| Nurse Practitioner primary | 363L00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.