Individual
JEAN A MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
222 E MEDICAL LN STE 101, WEST COLUMBIA, SC 29169-4847
(803) 739-3660
(803) 739-3663
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
471
SC
363LA2200X
Adult Health Nurse Practitioner
A27281
SC
363LA2200X
Adult Health Nurse Practitioner
APN471
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2041
—
SC
Enumeration date
03/01/2006
Last updated
11/09/2020
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