Individual
JANET L DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12 MEADOWLAKE RD, BLAIR, SC 29015-8997
(803) 945-7595
(803) 945-7596
Mailing address
1228 HARDEN ST, COLUMBIA, SC 29204-1800
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26995
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC030
—
SC
05
—
FQC043
—
SC
05
—
NP0733
—
SC
Enumeration date
02/06/2006
Last updated
08/09/2013
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