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General NPI Number Information
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NPI Number | 1114342839
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Entity Type | Individual
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Provider Name | SARA FRANCES JASPER AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 9228 MEDICAL PLAZA DR
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City | CHARLESTON
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State | SC
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Zip | 29406-9125
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Country | US
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Telephone | 843-574-5693
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Fax | 843-764-4512
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Provider Business Mailing Address
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Address Line | 9228 MEDICAL PLAZA DR
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City | CHARLESTON
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State | SC
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Zip | 29406-9125
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Country | US
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Telephone | 843-574-5693
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Fax | 843-764-4512
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 664365-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | F430887
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 22260
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22260
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License Number State | SC
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