MEDICARE: MS. MARY J DINAPOLI APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	APN27314	SC
2	363LA2200X	Adult Health Nurse Practitioner	26NJ00192600	NJ

General Provider Information

NPI Number	:	1396988309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY J DINAPOLI APN

Provider Business Mailing Address
First Line	:	3205 GREAT EGRET DR
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-9026
Country	:	US
Telephone Number	:	843-955-0492
Fax Number	:

Provider Business Practice Location Address
First Line	:	3205 GREAT EGRET DR
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-9026
Country	:	US
Telephone Number	:	843-955-0492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	03/25/2026

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