Individual
MARY E DANNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1316 N LAKE DR, LEXINGTON, SC 29072-7653
(803) 358-1191
(803) 358-1180
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN 380
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1849
—
SC
Enumeration date
04/12/2006
Last updated
03/16/2018
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