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General NPI Number Information
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NPI Number | 1003779380
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Entity Type | Individual
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Provider Name | VANESSA JIVERS RN
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Gender | Female
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 919 TRUE ST STE H
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City | COLUMBIA
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State | SC
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Zip | 29209-1662
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Country | US
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Telephone | 839-223-0831
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Fax | 803-233-4239
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Provider Business Mailing Address
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Address Line | 3 ANCHOR CT
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City | COLUMBIA
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State | SC
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Zip | 29229-7327
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Country | US
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Telephone | 839-223-0831
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number | 008729661
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License Number State | SC
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