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General NPI Number Information
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NPI Number | 1194053595
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Entity Type | Individual
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Provider Name | KEZIA MCDANIEL NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 7418 GARNERS FERRY RD
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City | COLUMBIA
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State | SC
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Zip | 29209-2601
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Country | US
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Telephone | 803-509-6310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 484
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City | EASLEY
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State | SC
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Zip | 29641-0484
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Country | US
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Telephone | 864-546-4497
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Fax | 864-546-4506
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4053
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License Number State | SC
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