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General NPI Number Information
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NPI Number | 1346738168
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Entity Type | Individual
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Provider Name | JOHN DAVIS GARREN NP
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Gender | Male
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | UPSTATE CARDIOLOGY 2 INNOVATION DRIVE, STE 400
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City | GREENVILLE
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State | SC
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Zip | 29607-5270
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Country | US
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Telephone | 864-235-7665
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Fax | 864-233-5971
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Provider Business Mailing Address
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Address Line | PO BOX 743294
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City | ATLANTA
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State | GA
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Zip | 30374-3294
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Country | US
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Telephone | 864-605-3721
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Fax | 864-605-3587
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 21759
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 21759
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 21759
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License Number State | SC
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