Individual
JENNIFER LUCAS REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
214 W PINE ST, FLORENCE, SC 29501-4725
(843) 661-0500
(436) 617-3708
Mailing address
214 W PINE ST, FLORENCE, SC 29501-4725
(843) 661-0500
(843) 661-7370
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
25211
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54-25211
CONTROLLED SUBSTANCE
SC
01
—
APN25211
SC LLR
SC
Enumeration date
08/25/2021
Last updated
03/25/2025
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