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General NPI Number Information
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NPI Number | 1124050281
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Entity Type | Individual
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Provider Name | JENNIFER CALABRESE FNP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 105 INDUSTRIAL WAY
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City | DARLINGTON
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State | SC
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Zip | 29532
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Country | US
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Telephone | 843-395-0015
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Fax | 843-393-0971
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Provider Business Mailing Address
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Address Line | PO BOX 799
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City | DARLINGTON
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State | SC
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Zip | 29540-0799
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Country | US
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Telephone | 843-395-0015
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Fax | 843-393-0971
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F1192
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License Number State | SC
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