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Daisha Jerrice Green, NP
Family Nurse Practitioner in Hartsville, South Carolina
NPI 1184394918

Daisha Jerrice Green is a Family Nurse Practitioner based in Hartsville, SC and is specialized in Family. Daisha Jerrice Green practices in Hartsville, SC and has the professional credentials of NP. The NPI Number for Daisha Jerrice Green is 1184394918 and holds a License No. 25391 (South Carolina).

The current practice location address for Daisha Jerrice Green is 1268 S 4Th St, Hartsville, SC and can be reached out via phone at 843-332-3422.

Location: 1268 S 4Th St, Hartsville, SC, 29551-1090
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184394918
Provider Name
Daisha Jerrice Green
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
1268 S 4Th St, Hartsville, SC, 29551-1090
Phone Number
843-332-3422
Fax Number
Provider Enumeration Date
09/14/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
SCM494 01 SC MEDICARE
NP8242 05 SC
institution
Provider Business Practice Location Address Details
Address
1268 S 4Th St
City
Hartsville
State
South Carolina
Zip
29550-0703
Phone Number
843-332-3422
Fax Number
person
Provider Business Mailing Address Details
Address
1268 S 4Th St
City
Hartsville
State
South Carolina
Zip
29550-0703
Phone Number
843-332-3422
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
25391 (South Carolina)
Definition
Definition to come...
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