Healthcare Provider Details

I. General information

NPI: 1114342839
Provider Name (Legal Business Name): SARA FRANCES JASPER AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH FRANCES BEACHLER NP

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 MEDICAL PLAZA DR
CHARLESTON SC
29406-9125
US

IV. Provider business mailing address

9228 MEDICAL PLAZA DR
CHARLESTON SC
29406-9125
US

V. Phone/Fax

Practice location:
  • Phone: 843-574-5693
  • Fax: 843-764-4512
Mailing address:
  • Phone: 843-574-5693
  • Fax: 843-764-4512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number664365-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF430887
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number22260
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number22260
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: