Doctor Name: | MARY G. DANIELS |
NPI Number: | 1528172384 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | APN2415 |
Business Practice Address: | 139 Main St Olanta, SC - 29114 |
Business Phone Number: | 8433964619 |
Business Fax Number: | 8433964503 |
Mailing Address: | 12 W South St, MANNING |
State: | SC |
Postal Code: | 291022925 |
Phone Number: | 8034336790 |
Fax Number: | 8034336796 |
NPI Enumeration Date: | 08/18/2006 |
NPI Last Update Date: | 12/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN2415 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |