Individual
SAMANTHA JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
Mailing address
125 BACKHALL RD, SAINT STEPHEN, SC 29479-3593
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
18613
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
18613
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
12/10/2013
Last updated
05/02/2023
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