Individual
JENNIFER LEE BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572-4183
(843) 497-7772
(843) 848-7530
Mailing address
920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572-4183
(843) 497-7772
(843) 848-7530
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
25112
SC
Other
Enumeration date
03/19/2021
Last updated
08/05/2021
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