Provider Demographics
NPI:1720402753
Name:NEWTON, JENNIFER M (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:NEWTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 OLD CLEMSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-4203
Mailing Address - Country:US
Mailing Address - Phone:803-753-7170
Mailing Address - Fax:803-753-7170
Practice Address - Street 1:795 OLD CLEMSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-4203
Practice Address - Country:US
Practice Address - Phone:803-744-4940
Practice Address - Fax:803-744-4938
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20970363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care