Individual
JORDAN R BARHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
146 E HOSPITAL DR STE 120A, WEST COLUMBIA, SC 29169
(803) 936-7076
(803) 936-7925
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
20424
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5036
—
SC
Enumeration date
08/22/2016
Last updated
10/13/2020
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