Individual
MARY TAYLOR BRITT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5010
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24213
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24213
NURSE PRACTITIONER STATE LICENSE
SC
Enumeration date
08/27/2020
Last updated
07/17/2024
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