Healthcare Provider Details

I. General information

NPI: 1477629582
Provider Name (Legal Business Name): NANCY RAGAN CANADAY R.N.,C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 COLONIAL DRIVE
COLUMBIA SC
29203
US

IV. Provider business mailing address

960 RIVERVIEW DRIVE
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-4777
  • Fax: 803-898-4855
Mailing address:
  • Phone: 803-794-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number17495
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: