Pittard, Jennifer Moon

Pittard, Jennifer Moon is an individual health care provider with primary practice located at 811 W Main St Ste 201&209 , Lexington SC 29072-2507. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Pittard, Jennifer Moon can be contacted via phone (803) 785-4777.

Contact Information

Primary practice address
811 W Main St Ste 201&209 Lexington SC 29072-2507
Phone: (803) 785-4777
Fax: (803) 358-6240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 21335 South Carolina

Profile Details

NPI number 1730698580
LBN Legal business name Pittard, Jennifer Moon
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2017
Last updated Nov 21st, 2023 - 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 1730698580 NPPES
South Carolina MEDICAID NP4799

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