Provider Demographics
NPI:1346667490
Name:MCFADDIN, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:MCFADDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-3454
Mailing Address - Country:US
Mailing Address - Phone:803-435-4355
Mailing Address - Fax:803-435-2065
Practice Address - Street 1:3 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-3454
Practice Address - Country:US
Practice Address - Phone:803-435-4355
Practice Address - Fax:803-435-2065
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC217302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse