Individual
JENNIFER LEE MIKOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9313 MEDICAL PLAZA DR STE 103, NORTH CHARLESTON, SC 29406-9802
(843) 790-8280
Mailing address
9313 MEDICAL PLAZA DR STE 103, NORTH CHARLESTON, SC 29406-9802
(843) 790-8280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2194
MA
363A00000X
Physician Assistant
Primary
2231
SC
Other
Enumeration date
09/15/2006
Last updated
07/11/2025
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