Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 239917 | SC |
NPI | 1033737903 |
---|---|
Provider Name | Danielle Ledwell |
First Address | North Charleston, SC 29405-4158 |
Second Address | Charleston, SC 29401-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2020 |
Last Update Date | 08/07/2020 |