Provider Demographics
NPI:1689755118
Name:CAHILL, JOANNE LOUISE (FNP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:LOUISE
Last Name:CAHILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W RUTHERFORD ST
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-1526
Mailing Address - Country:US
Mailing Address - Phone:864-457-2363
Mailing Address - Fax:864-457-2736
Practice Address - Street 1:108 W RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:LANDRUM
Practice Address - State:SC
Practice Address - Zip Code:29356-1526
Practice Address - Country:US
Practice Address - Phone:864-457-2363
Practice Address - Fax:864-457-2736
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007486363LF0000X
SC17797363LF0000X
NC5005861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2666Medicaid
SCNP2666Medicaid