Individual
JILLIAN O. EADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
19044
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4120
—
SC
Enumeration date
11/19/2014
Last updated
11/02/2022
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