Provider Demographics
NPI:1255859682
Name:CAUBLE, JESSICA LEOPARD (FNPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEOPARD
Last Name:CAUBLE
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-454-5110
Mailing Address - Fax:864-241-9206
Practice Address - Street 1:996 MEDICAL RIDGE RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-4541
Practice Address - Country:US
Practice Address - Phone:864-833-5654
Practice Address - Fax:864-833-2786
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily