Healthcare Provider Details
I. General information
NPI: 1679280697
Provider Name (Legal Business Name): ELIZABETH JESSEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2022
Last Update Date: 08/04/2025
Certification Date: 10/30/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
SC HOUSE CALLS INC. 111 DOCTORS CIR.
COLUMBIA SC
29203
US
IV. Provider business mailing address
SC HOUSE CALLS INC. 111 DOCTORS CIR.
COLUMBIA SC
29203
US
V. Phone/Fax
- Phone: 800-491-0909
- Fax:
- Phone: 800-491-0909
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 26601 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: