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Individual

JESSICA E NEWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
222 E MEDICAL LN STE 101, WEST COLUMBIA, SC 29169-4850
(803) 739-3660
(803) 739-3663
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 753-5591

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21614
SC
363LP2300X
Primary Care Nurse Practitioner
21614
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP5251
SC
Enumeration date
02/09/2018
Last updated
11/10/2020
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