CHANELLE JACKSON

COLUMBIA, SC
NPI1629510862
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  20603)
Enumeration Date2016-11-04
Last Update Date2024-01-12
Business Address
CHANELLE JACKSON APRN
229 LONGTOWN RD
COLUMBIA, SC 29229-8550
Phone number: 803-419-4949
Mailing Address
CHANELLE JACKSON APRN
PO BOX 6069
WEST COLUMBIA, SC 29171-6069
Phone number: 803-935-8292
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