Healthcare Provider Details

I. General information

NPI: 1801366505
Provider Name (Legal Business Name): DANIELLE NICOLE GRIFFIN MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 SUTTON RD S STE 101
FORT MILL SC
29715-8439
US

IV. Provider business mailing address

343 PLEASANT CREEK CT
LEXINGTON SC
29073-9757
US

V. Phone/Fax

Practice location:
  • Phone: 803-328-6306
  • Fax: 803-909-6451
Mailing address:
  • Phone: 803-260-9968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number22738
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011737
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22738
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: