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General NPI Number Information
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NPI Number | 1679928428
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Entity Type | Individual
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Provider Name | STELINA JENNINGS NP
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Gender | Female
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | 2 INNOVATION DRIVE STE 400
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City | GREENVILLE
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State | SC
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Zip | 29607
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Country | US
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Telephone | 864-915-1939
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Fax |
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Provider Business Mailing Address
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Address Line | 2 INNOVATION DRIVE
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City | GREENVILLE
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State | SC
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Zip | 29607
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Country | US
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Telephone | 864-235-7665
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 20034
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License Number State | SC
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