Individual
MRS. JENNIFER FUNDERBURK SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2021 BRIDGEMILL DR, INDIAN LAND, SC 29707-9210
(803) 416-5410
Mailing address
PO BOX 23321, NEW YORK, NY 10087-4321
(843) 876-1344
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28483
SC
Other
Enumeration date
04/20/2024
Last updated
05/06/2024
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