Healthcare Provider Details

I. General information

NPI: 1265144554
Provider Name (Legal Business Name): DARA LANE JARRETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 N CHURCH ST STE 701
SPARTANBURG SC
29303-3003
US

IV. Provider business mailing address

PO BOX 743070
ATLANTA GA
30374-3070
US

V. Phone/Fax

Practice location:
  • Phone: 864-560-1600
  • Fax: 864-560-1655
Mailing address:
  • Phone: 864-560-4304
  • Fax: 864-560-4413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26958
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: