Provider Demographics
NPI:1528844081
Name:MORALES, DAIMA (APRN)
Entity type:Individual
Prefix:
First Name:DAIMA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 GOLD HILL RD STE 204
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6965
Mailing Address - Country:US
Mailing Address - Phone:803-228-4038
Mailing Address - Fax:866-884-5371
Practice Address - Street 1:852 GOLD HILL RD STE 204
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6965
Practice Address - Country:US
Practice Address - Phone:803-228-4038
Practice Address - Fax:866-884-5371
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC318446163WP0808X
SC28420363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health