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1235709395
JENNI LISA HACKENBERG
SUMMERVILLE, SC
NPI
1235709395
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 25116)
Enumeration Date
2021-06-30
Last Update Date
2021-06-30
Business Address
JENNI LISA HACKENBERG
1709 OLD TROLLEY RD
SUMMERVILLE, SC 29485-8276
Phone number: 843-873-2225
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Mailing Address
JENNI LISA HACKENBERG
621 VAN BUREN DR
SUMMERVILLE, SC 29486-0405
Phone number: 803-522-4570
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