Healthcare Provider Details

I. General information

NPI: 1689755118
Provider Name (Legal Business Name): JOANNE LOUISE CAHILL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W RUTHERFORD ST
LANDRUM SC
29356-1526
US

IV. Provider business mailing address

108 W RUTHERFORD ST
LANDRUM SC
29356-1526
US

V. Phone/Fax

Practice location:
  • Phone: 864-457-2363
  • Fax: 864-457-2736
Mailing address:
  • Phone: 864-457-2363
  • Fax: 864-457-2736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP007486
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17797
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5005861
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: