Healthcare Provider Details

I. General information

NPI: 1154226272
Provider Name (Legal Business Name): ASHLEY DONIPHAN MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CALLEN BLVD STE 200
SUMMERVILLE SC
29486-2816
US

IV. Provider business mailing address

1022 ARROWWOOD WAY
SUMMERVILLE SC
29485-9226
US

V. Phone/Fax

Practice location:
  • Phone: 843-723-8823
  • Fax: 843-606-8059
Mailing address:
  • Phone: 843-991-2176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number32745
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32745
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: