Provider Demographics
NPI:1710491022
Name:AUGERI, JESSICA GAYLE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GAYLE
Last Name:AUGERI
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:645-228-6038
Mailing Address - Fax:
Practice Address - Street 1:905 VERDAE BLVD STE 204
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4098
Practice Address - Country:US
Practice Address - Phone:864-255-5609
Practice Address - Fax:864-240-5028
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21378363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCI3805206OtherMEDICARE PIN
SC4291PAMedicaid