Individual
CRYSTAL ANN JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
331 E. MAIN ST., SUITE 200, ROCK HILL, SC 29730
(803) 909-9598
(803) 909-9301
Mailing address
331 E MAIN ST STE 200, ROCK HILL, SC 29730-5384
(803) 909-9598
(803) 909-9301
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
IHCP-1594
SC
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
246RP1900X
Phlebotomy Technician
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
310400000X
Assisted Living Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
Primary
166695
SC
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166696
CNA
SC
01
—
419524
CNA
NC
Enumeration date
07/08/2020
Last updated
08/25/2022
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