Stogsdill, Jennifer Rae

Stogsdill, Jennifer Rae is an individual health care provider with primary practice located at 8004 Myrtle Trace Dr Ste 200 , Conway SC 29526-8945. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Stogsdill, Jennifer Rae can be contacted via phone (843) 347-8041.

Contact Information

Primary practice address
8004 Myrtle Trace Dr Ste 200 Conway SC 29526-8945
Phone: (843) 347-8041
Fax: (843) 347-8042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4186 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 4186 South Carolina

Profile Details

NPI number 1548924079
LBN Legal business name Stogsdill, Jennifer Rae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2021
Last updated Aug 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 1548924079 NPPES
South Carolina MEDICAID 5009PA

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