Individual
JENNIFER CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 766-7103
(843) 763-3834
Mailing address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 766-7103
(843) 763-3834
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20157
SC
363LP2300X
Primary Care Nurse Practitioner
R0105340
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20157
—
SC
Enumeration date
09/03/2015
Last updated
10/17/2016
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