Eaddy, Jillian O.

Eaddy, Jillian O. is an individual health care provider with primary practice located at 111 Doctor Cir , Columbia SC 29203-6502. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Eaddy, Jillian O. can be contacted via phone (800) 491-0909.

Contact Information

Primary practice address
111 Doctor Cir Columbia SC 29203-6502
Phone: (800) 491-0909
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 19044 South Carolina

Profile Details

NPI number 1417354473
LBN Legal business name Eaddy, Jillian O.
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2014
Last updated Nov 2nd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417354473 NPPES
South Carolina MEDICAID NP4120

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