=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235570599
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER HORTON GILREATH NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2013
-----------------------------------------------------
Last Update Date | 04/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1394 JACKSON GROVE RD
-----------------------------------------------------
City | TRAVELERS REST
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29690-8832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-316-9402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1394 JACKSON GROVE RD
-----------------------------------------------------
City | TRAVELERS REST
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29690-8832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-316-9402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine Registered Nurse
-----------------------------------------------------
License Number | 84316
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 18313
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------