MEDICARE: DANYELL PAGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	107274	SC

General Provider Information

NPI Number	:	1568889392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANYELL PAGE

Provider Business Mailing Address
First Line	:	201 W HAMPTON ST
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-3333
Country	:	US
Telephone Number	:	843-774-5611
Fax Number	:	843-841-0835

Provider Business Practice Location Address
First Line	:	201 W HAMPTON ST
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-3333
Country	:	US
Telephone Number	:	843-774-5611
Fax Number	:	843-841-0835

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2014
Last Update Date	:	03/18/2014

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Directions to “ DANYELL PAGE ” Practice Location

Language	Start Address	Practice Location

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