Individual
MRS. JENNIFER MOON PITTARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
811 W MAIN ST STE 201&209, LEXINGTON, SC 29072-2507
(803) 785-4777
(803) 358-6240
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 785-4777
(803) 358-6240
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
21335
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4799
—
SC
Enumeration date
09/25/2017
Last updated
11/21/2023
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