Stafford, Jackie P.

Stafford, Jackie P. is an individual health care provider with primary practice located at 710 Chesterfield Hwy , Cheraw SC 29520-7001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Stafford, Jackie P. can be contacted via phone (843) 537-2171.

Contact Information

Primary practice address
710 Chesterfield Hwy Cheraw SC 29520-7001
Phone: (843) 537-2171
Fax: (843) 537-5926
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 17625 South Carolina

Profile Details

NPI number 1609150622
LBN Legal business name Stafford, Jackie P.
Credentials DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2011
Last updated Feb 22nd, 2021 - about 4 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 1609150622 NPPES
South Carolina MEDICAID NP1947

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