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Individual

JACKSON LANE MCRAE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, BSN

Contact information

Practice address
305 RUSSELL ST, DARLINGTON, SC 29532-3304
(843) 398-4400
(843) 398-4418
Mailing address
305 RUSSELL ST, DARLINGTON, SC 29532-3304
(843) 398-4400
(843) 398-4418

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
232265
SC

Other

Enumeration date
05/05/2020
Last updated
05/05/2020
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