Healthcare Provider Details

I. General information

NPI: 1649684267
Provider Name (Legal Business Name): DANA RENEE GARNAND FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BAYLOR DR STE 205
BLUFFTON SC
29910-8965
US

IV. Provider business mailing address

PO BOX 37643
BELFAST ME
04915-1218
US

V. Phone/Fax

Practice location:
  • Phone: 843-706-2255
  • Fax: 843-706-2257
Mailing address:
  • Phone: 843-682-7480
  • Fax: 843-681-9169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024171515
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28611
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: