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General NPI Number Information
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NPI Number | 1649178401
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Entity Type | Organization
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Legal Business Name | JENNINGS HEALTH GROUP LLC
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Dates
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Enumeration Date | 10/29/2026
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Last Update Date | 10/29/2026
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Provider Practice Location Address
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Address Line | 117 SAINT JAMES ST APT A
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City | GEORGETOWN
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State | SC
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Zip | 29440-3793
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Country | US
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Telephone | 864-325-4058
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Fax |
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Provider Business Mailing Address
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Address Line | 117 SAINT JAMES ST APT A
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City | GEORGETOWN
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State | SC
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Zip | 29440-3793
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Country | US
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Telephone | 864-325-4058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LEIGH WATTS
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Credential | FNP-C
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Telephone | 864-325-4058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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