Provider Demographics
NPI:1306723903
Name:DODDS, JESSICA KEELIN (DNP-FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KEELIN
Last Name:DODDS
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 WATTS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4358
Mailing Address - Country:US
Mailing Address - Phone:864-569-5713
Mailing Address - Fax:
Practice Address - Street 1:5208 CALHOUN MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3864
Practice Address - Country:US
Practice Address - Phone:864-307-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2024002072363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner