Individual
CHRISTINA JOCKLENE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
2750 LAUREL ST STE 103, COLUMBIA, SC 29204-2023
(803) 865-4934
(803) 865-4935
Mailing address
172 HUNTERS MILL LN, WEST COLUMBIA, SC 29170-1279
(843) 240-3041
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
28779
SC
363L00000X
Nurse Practitioner
Primary
28779
SC
363LP2300X
Primary Care Nurse Practitioner
28779
SC
Other
Enumeration date
07/08/2024
Last updated
09/24/2024
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