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General NPI Number Information
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NPI Number | 1417316449
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Entity Type | Individual
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Provider Name | JOBY K JANARDHANAN AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 920 DOUG WHITE DR STE 130
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4180
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Country | US
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Telephone | 843-848-1440
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Fax | 843-839-1654
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Provider Business Mailing Address
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Address Line | 920 DOUG WHITE DR STE 130
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4180
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Country | US
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Telephone | 843-848-1440
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Fax | 843-839-1654
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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 | 30771
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 8430
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 8430
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License Number State | AZ
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