Healthcare Provider Details

I. General information

NPI: 1023939378
Provider Name (Legal Business Name): JOSHUA HARRISON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

IV. Provider business mailing address

3113 CRICKENTREE LN
FLORENCE SC
29501-0224
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-6613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number217637
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: