Individual
DANIELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
812 STATE RD, CHERAW, SC 29520-7113
(843) 537-0961
(843) 537-0908
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
(843) 857-0111
(843) 857-0206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19900
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4520
—
SC
01
—
SCA714
MEDICARE
SC
Enumeration date
07/07/2016
Last updated
03/20/2024
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