Doctor Name: | JULIANNA MAYNOR |
NPI Number: | 1093049470 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 3872 |
Business Practice Address: | 2845 E Highway 76 Suite 5 Mullins, SC - 295746037 |
Business Phone Number: | 8434312650 |
Business Fax Number: | 8434312647 |
Mailing Address: | 2845 E Highway 76, Suite 5 MULLINS |
State: | SC |
Postal Code: | 295746037 |
Phone Number: | 8434312650 |
Fax Number: | 8434312647 |
NPI Enumeration Date: | 10/01/2009 |
NPI Last Update Date: | 06/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 3872 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |