Individual
MS. JENNIFER O GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4540 TRENHOLM RD, COLUMBIA, SC 29206-4462
(803) 790-4700
(803) 790-6130
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
18120
SC
Other
Enumeration date
02/07/2013
Last updated
10/27/2020
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