Individual
JESSICA LYNN MAFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
167 S GREENWOOD AVE, WARE SHOALS, SC 29692-1636
(864) 389-4116
Mailing address
103 LANETT ST, GREENWOOD, SC 29649-1029
(864) 389-4116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26785
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26785
SCLLR
SC
Enumeration date
11/10/2022
Last updated
11/10/2022
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