Healthcare Provider Details

I. General information

NPI: 1932999018
Provider Name (Legal Business Name): JEANNA MARIE DAUZY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 E COLUMBIA AVE
BATESBURG LEESVILLE SC
29070-9285
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-604-0066
  • Fax: 803-604-3263
Mailing address:
  • Phone: 803-791-2491
  • Fax: 803-794-5960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number30553
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: