CHARNELE VONTESE JACKSON

SUMTER, SC
NPI1932778107
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  25444)
Additional Taxonomies207Q00000X Family Medicine
(Licence: SC  25444)
207QA0505X Family Medicine, Adult Medicine
(Licence: SC  542224)
Enumeration Date2021-06-22
Last Update Date2025-02-26
Business Address
CHARNELE VONTESE JACKSON DnP
531 OXFORD ST STE C2
SUMTER, SC 29150-3300
Phone number: 803-295-0649
Mailing Address
CHARNELE VONTESE JACKSON DnP
1712 NICHOLAS DR
SUMTER, SC 29154-7909
Phone number: 803-316-4581