Provider Demographics
NPI:1245323484
Name:FARR, DANNAH MITCHELL (RN)
Entity type:Individual
Prefix:MRS
First Name:DANNAH
Middle Name:MITCHELL
Last Name:FARR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CAROLINA NURSING
Other - Middle Name:ASSOCIATES
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:106 E BUTLER RD STE A
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2154
Mailing Address - Country:US
Mailing Address - Phone:864-676-0020
Mailing Address - Fax:864-676-0021
Practice Address - Street 1:880 S PLEASANTBURG DR STE 2E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2451
Practice Address - Country:US
Practice Address - Phone:864-370-7200
Practice Address - Fax:864-370-7200
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88004251E00000X, 305R00000X, 3747P1801X
SCIHCP-0086253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0801Medicaid
SCIHCP-0086OtherDHEC