Individual
JEWEL D SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12832
SC
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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