Individual
JONATHAN DOUGLAS TESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
853 N CHURCH ST STE 620, SPARTANBURG, SC 29303-3070
(864) 573-7511
(864) 560-1690
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 979-5455
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23131
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6821
—
SC
01
—
SCJ5295206
MEDICARE PIN
SC
Enumeration date
03/30/2020
Last updated
02/24/2021
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