Healthcare Provider Details

I. General information

NPI: 1518967058
Provider Name (Legal Business Name): DAWN C MILLS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 TRICOM ST
N CHARLESTON SC
29406-9172
US

IV. Provider business mailing address

110 NNPTC CIR
GOOSE CREEK SC
29445-6314
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-1770
  • Fax:
Mailing address:
  • Phone: 843-577-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1416
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: