Individual
JANE ELIZABETH WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
545 SUMTER HWY, BISHOPVILLE, SC 29010-7601
(803) 484-5317
Mailing address
545 SUMTER HWY, BISHOPVILLE, SC 29010-7601
(803) 484-5317
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN3220
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1114
—
SC
01
—
P00906571
RAILROAD MEDICARE PTAN
SC
Enumeration date
06/13/2007
Last updated
08/29/2023
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