Individual
MR. COLEY JACOB OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
2828 BAYBORO ST, LORIS, SC 29569-2710
(843) 716-2229
Mailing address
3544 RAYNER COVE CT, LITTLE RIVER, SC 29566-5407
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
31233
SC
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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