| Doctor Name: | LOGAN JESSICA CAMP |
| NPI Number: | 1346684933 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | 204836 |
| Business Practice Address: | 4801 Highway 9 Inman, SC - 293498003 |
| Business Phone Number: | 8645785954 |
| Business Fax Number: | 8645995489 |
| Mailing Address: | 4801 Highway 9, INMAN |
| State: | SC |
| Postal Code: | 293498003 |
| Phone Number: | 8645785954 |
| Fax Number: | 8645995489 |
| NPI Enumeration Date: | 04/25/2013 |
| NPI Last Update Date: | 04/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 204836 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |