Individual
JENNINGS MICHAEL PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1301 48TH AVE N # A-2, MYRTLE BEACH, SC 29577-5427
(843) 855-2299
Mailing address
728 CONIFER CT, MYRTLE BEACH, SC 29572-4172
(614) 203-3515
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
353367
OH
363LF0000X
Family Nurse Practitioner
17756
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
20499
SC
Other
Enumeration date
05/26/2011
Last updated
02/19/2025
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