CHARNELE VONTESE JACKSON

SUMTER, SC
NPI1932778107
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  25444)
Additional Taxonomies163WC1500X Registered Nurse, Community Health
(Licence: SC  227658)
Enumeration Date2021-06-22
Last Update Date2021-09-27
Business Address
CHARNELE VONTESE JACKSON
105 N MAGNOLIA ST
SUMTER, SC 29150-4941
Phone number: 803-934-2806
Mailing Address
CHARNELE VONTESE JACKSON
1712 NICHOLAS DR
SUMTER, SC 29154-7909
Phone number: 803-316-4581