Individual
JENNIFER ANN MCQUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LNP
Contact information
Practice address
7735 FARR ST APT 602, DANIEL ISLAND, SC 29492-6405
(540) 336-8512
Mailing address
7735 FARR ST APT 602, DANIEL ISLAND, SC 29492-6405
(540) 336-8512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0017000701
SC
363LF0000X
Family Nurse Practitioner
0017000701
VA
Other
Enumeration date
01/16/2007
Last updated
08/04/2011
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