Healthcare Provider Details

I. General information

NPI: 1124050281
Provider Name (Legal Business Name): JENNIFER CALABRESE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 INDUSTRIAL WAY
DARLINGTON SC
29532
US

IV. Provider business mailing address

105 INDUSTRIAL WAY
DARLINGTON SC
29532-6222
US

V. Phone/Fax

Practice location:
  • Phone: 843-395-0015
  • Fax: 843-393-0971
Mailing address:
  • Phone: 843-395-0015
  • Fax: 843-393-0971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF1192
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: