Individual
JENNIFER COLLEEN LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
332 ESHER CT, MYRTLE BEACH, SC 29579-3325
(540) 446-4327
Mailing address
332 ESHER CT, MYRTLE BEACH, SC 29579-3325
(540) 446-4327
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
108447
SC
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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