Individual
JORDAN CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
631 JOHNNIE DODDS BLVD, MOUNT PLEASANT, SC 29464-3030
(843) 881-0815
Mailing address
1510 PRIVATEER DR, MOUNT PLEASANT, SC 29464-4923
(919) 280-0229
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25228
SC
363LF0000X
Family Nurse Practitioner
APN.0995884-NP
CO
Other
Enumeration date
11/12/2020
Last updated
08/10/2021
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