Provider Demographics
NPI:1104395474
Name:LINDSAY, JASMINE NASHAUN
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:NASHAUN
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 JETER CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-8186
Mailing Address - Country:US
Mailing Address - Phone:803-760-6961
Mailing Address - Fax:
Practice Address - Street 1:2136 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-9456
Practice Address - Country:US
Practice Address - Phone:864-486-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist