Individual
JOHANA ROCIO FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP ANP-BC
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0005
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
21577
SC
Other
Enumeration date
04/24/2012
Last updated
03/17/2018
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