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Individual

MRS. LAQUINTA JAMETTE GLENN-REESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
222 E MEDICAL LN STE 400, WEST COLUMBIA, SC 29169-4848
(803) 794-7511
(803) 794-7751
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2491

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
21845
SC
363LF0000X
Family Nurse Practitioner
21845
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP5950
SC
Enumeration date
04/29/2019
Last updated
03/18/2026
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