Basic Information
| Provider Information | |||||||||
| NPI: | 1568404648 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRITT | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7182 WOODROW ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | IRMO | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290632832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037491111 | ||||||||
| FaxNumber: | 8037490050 | ||||||||
| Practice Location | |||||||||
| Address1: | 7182 WOODROW ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | IRMO | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290632832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037491111 | ||||||||
| FaxNumber: | 8037490050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 09/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 2928 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 2928 | 01 | SC | LICENSE | OTHER |