Healthcare Provider Details

I. General information

NPI: 1740988518
Provider Name (Legal Business Name): MEGAN JOYNER DAVISON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3799 12TH STREET EXT STE 105
CAYCE SC
29033-3750
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-926-6820
  • Fax:
Mailing address:
  • Phone: 803-935-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number222996
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: