Individual
MARY G. DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
139 MAIN ST, OLANTA, SC 29114
(843) 396-4619
(843) 396-4503
Mailing address
12 W SOUTH ST, MANNING, SC 29102-2925
(803) 433-6790
(803) 433-6796
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN2415
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0238
—
SC
Enumeration date
08/18/2006
Last updated
12/21/2010
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