Healthcare Provider Details

I. General information

NPI: 1154244978
Provider Name (Legal Business Name): JAIME LYNN QUINN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIME WARD

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 NEXTON PKWY STE 104
SUMMERVILLE SC
29486-3169
US

IV. Provider business mailing address

PO BOX 632516
CINCINNATI OH
45263-2516
US

V. Phone/Fax

Practice location:
  • Phone: 843-212-8080
  • Fax: 843-402-2681
Mailing address:
  • Phone: 888-472-0043
  • Fax: 513-653-4122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32483
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: