Provider Demographics
NPI:1780753996
Name:LACHICOTTE, JENIFER (FNP)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:LACHICOTTE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 OCEAN HWY UNIT C
Mailing Address - Street 2:SUITE C
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6613
Mailing Address - Country:US
Mailing Address - Phone:843-237-5593
Mailing Address - Fax:843-314-3223
Practice Address - Street 1:10555 OCEAN HWY
Practice Address - Street 2:SUITE C
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6613
Practice Address - Country:US
Practice Address - Phone:843-237-5593
Practice Address - Fax:843-314-3223
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily