Provider Demographics
NPI:1326648858
Name:SMITH, MELANIE DANIELS (RN)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:DANIELS
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 JOAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536
Mailing Address - Country:US
Mailing Address - Phone:843-774-1212
Mailing Address - Fax:843-841-3616
Practice Address - Street 1:1803 JOAN DRIVE
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536
Practice Address - Country:US
Practice Address - Phone:843-774-1212
Practice Address - Fax:843-841-3616
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC74985163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse