Provider Demographics
NPI:1881084192
Name:STUTTS, JENNIFER TURBEVILLE (FNP-BC, APRN, MSN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:TURBEVILLE
Last Name:STUTTS
Suffix:
Gender:
Credentials:FNP-BC, APRN, MSN
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:REAN
Other - Last Name:TURBEVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC, APRN
Mailing Address - Street 1:1456 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2339
Mailing Address - Country:US
Mailing Address - Phone:803-693-6100
Mailing Address - Fax:803-693-6100
Practice Address - Street 1:1456 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2339
Practice Address - Country:US
Practice Address - Phone:803-693-6100
Practice Address - Fax:803-746-0923
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008175363LP2300X, 363LF0000X
SC19275363LP2300X, 2084P0800X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC19275OtherSC APRN LICENSE