Doctor Name: | MRS. JENNIFER LEE FELTWELL |
NPI Number: | 1083903900 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 4457 |
Business Practice Address: | 698 Fairview Rd Simpsonville, SC - 296806708 |
Business Phone Number: | 8038656680 |
Business Fax Number: | |
Mailing Address: | 698 Fairview Rd, SIMPSONVILLE |
State: | SC |
Postal Code: | 296806708 |
Phone Number: | 8038656680 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2011 |
NPI Last Update Date: | 12/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4457 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |