Individual
MS. DANA ELAINE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-FNP
Contact information
Practice address
102 SUMMERWOOD WAY, AIKEN, SC 29803-7704
(803) 649-5300
(803) 649-0056
Mailing address
102 SUMMERWOOD WAY, AIKEN, SC 29803-7704
(803) 649-5300
(803) 649-0056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4057
SC
363LP2300X
Primary Care Nurse Practitioner
4057
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582366418
TAX ID
—
Enumeration date
12/17/2008
Last updated
02/04/2020
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