Provider Demographics
NPI:1184038853
Name:ASHLEY, JENNIFER LANDRUM (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LANDRUM
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SAINT FRANCIS DR STE 125
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3900
Mailing Address - Country:US
Mailing Address - Phone:864-255-1304
Mailing Address - Fax:864-679-8955
Practice Address - Street 1:317 SAINT FRANCIS DR STE 125
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3900
Practice Address - Country:US
Practice Address - Phone:864-255-1304
Practice Address - Fax:864-679-8955
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily