Individual
JENNIFER JO PASSANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
345 FRESHFIELDS DRIVE, SUITE J101, JOHNS ISLAND, SC 29455-6323
(843) 768-4800
(843) 606-8039
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
659
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0232PA
—
SC
Enumeration date
05/01/2006
Last updated
05/11/2021
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