Individual
JENNY LEE DESART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 402-1436
(843) 402-1833
Mailing address
PO BOX 603484, CHARLOTTE, NC 28260-3484
(803) 765-1838
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
23729
SC
367500000X
Certified Registered Nurse Anesthetist
ARNP9297294
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012764400
—
FL
Enumeration date
06/26/2014
Last updated
05/15/2024
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