Individual
JACOB COWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
518 E CAROLINA AVE STE B, HARTSVILLE, SC 29550-4312
(843) 383-4426
(843) 383-8509
Mailing address
518 E CAROLINA AVE STE B, HARTSVILLE, SC 29550-4312
(843) 383-4426
(843) 383-8509
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3317
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20066947
SELECT HEALTH
SC
01
—
3317
SC LICENSE #
SC
05
—
NP1148
—
SC
Enumeration date
08/28/2007
Last updated
07/15/2015
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