Provider Demographics
NPI:1164909446
Name:CASH, JESSICA ANN (MS, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANN
Last Name:CASH
Suffix:
Gender:F
Credentials:MS, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:100 E WOOD ST STE 202
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3058
Practice Address - Country:US
Practice Address - Phone:864-560-7070
Practice Address - Fax:864-560-7033
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP5362Medicaid
SCSCD6416067OtherMEDICARE PIN
SCSCD6417628OtherMEDICARE PIN
SCSCD641J577OtherMEDICARE PIN
SCSCD6413365OtherMEDICARE PIN
SCSCD6416084OtherMEDICARE PIN