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General NPI Number Information
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NPI Number | 1609754837
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Entity Type | Individual
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Provider Name | LISA M MCNEILL RN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | TAYLOR AT MARION STREET
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City | COLUMBIA
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State | SC
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Zip | 29220-0001
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Country | US
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Telephone | 803-296-5010
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Fax |
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Provider Business Mailing Address
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Address Line | 796 BIG BEAVER CREEK RD
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City | SWANSEA
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State | SC
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Zip | 29160-9369
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Country | US
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Telephone | 803-378-2909
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 284172
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License Number State | SC
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