Individual
MRS. JACQUELYN NICOLE HANNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
200 FLEETWOOD DR, EASLEY, SC 29640-2022
(864) 455-7000
(864) 442-8279
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23767
SC
208M00000X
Hospitalist Physician
PENDING
SC
363LF0000X
Family Nurse Practitioner
Primary
23767
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6819
—
SC
Enumeration date
02/11/2020
Last updated
11/18/2025
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