Individual
JADE PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1676 N HIGHWAY 17, MOUNT PLEASANT, SC 29464-3310
(866) 389-2727
Mailing address
1676 N HIGHWAY 17, MOUNT PLEASANT, SC 29464-3310
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
31576
SC
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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