Provider Demographics
NPI:1871910760
Name:MITCHELL, DANIELLE TAYLOR (RN)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:TAYLOR
Last Name:MITCHELL
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 1:502 BIG CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-9415
Mailing Address - Country:US
Mailing Address - Phone:864-245-2402
Mailing Address - Fax:
Practice Address - Street 1:220 MCGEE RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2104
Practice Address - Country:US
Practice Address - Phone:864-260-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201159163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse