Provider Demographics
NPI:1255877007
Name:DAY, ANNA LEIGH
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LEIGH
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LEIGH
Other - Last Name:WILLIFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 SIGMA DR
Mailing Address - Street 2:100
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7715
Mailing Address - Country:US
Mailing Address - Phone:843-871-9440
Mailing Address - Fax:843-871-5932
Practice Address - Street 1:809 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6605
Practice Address - Country:US
Practice Address - Phone:843-871-9440
Practice Address - Fax:843-871-5932
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4331Medicaid
SCNP4331Medicaid