Kollock, Jennifer Ann

Kollock, Jennifer Ann is an individual health care provider with primary practice located at 220 Castleton Cir , Boiling Springs SC 29316-6230. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kollock, Jennifer Ann can be contacted via phone (704) 773-5896.

Contact Information

Primary practice address
220 Castleton Cir Boiling Springs SC 29316-6230
Phone: (704) 773-5896
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 22284 South Carolina

Profile Details

NPI number 1740755891
LBN Legal business name Kollock, Jennifer Ann
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2018
Last updated Jan 29th, 2021 - about 5 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 1740755891 NPPES
South Carolina Other SCG8286067 MEDICARE PIN
South Carolina MEDICAID NP5525 MEDICARE PIN
South Carolina Other SCD922J577 MEDICARE PIN
South Carolina Other SCG8286084 MEDICARE PIN

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