Healthcare Provider Details

I. General information

NPI: 1528473824
Provider Name (Legal Business Name): JENNIFER HALL AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER NICHOLSON AGNP

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HAMPSTEAD PL
GREER SC
29650-3659
US

IV. Provider business mailing address

112 SPARKS DR
FOREST CITY NC
28043-9021
US

V. Phone/Fax

Practice location:
  • Phone: 828-351-6000
  • Fax: 828-287-7436
Mailing address:
  • Phone: 828-351-6000
  • Fax: 828-287-7436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18813
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: