JACQUELYN SUZETTE AMMONS (NPI# 1669965810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669965810 |
Entity Type | Individual |
Full Name | JACQUELYN SUZETTE AMMONS |
Credential | ACNP |
Practice Address |
9330 Medical Plaza Dr Charleston SC 29406-9104 |
Mailing Address |
9330 Medical Plaza Dr North Charleston SC 29406-9104 |
Practice Telephone | 8438474876 |
Mailing Telephone | 8438474882 |
Enumeration Date | 2018-06-12 |
Last Update Date | 2018-10-01 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
21768 | SC | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ICC HEALTHCARE LLC | 1720210586 | 01 |
Street Address |
9330 MEDICAL PLAZA DR |
City | CHARLESTON |
State | SC |
Zip Code | 29406-9104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285632638 | Thomas A Privett | Psychiatry & Neurology | 9330 Medical Plaza Dr, Charleston, SC 29406 | 2005-07-11 |
1740896380 | Robert Palmer Wolfrom | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-09-18 |
1801415872 | Holly Robinson | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-04-10 |
1578192951 | Destine Hoover | Pharmacist | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-04-07 |
1134751829 | Julie Ivester Hayler | Nurse Practitioner | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-02-10 |
1659903078 | Elizabeth Mary Chouinard | Registered Nurse | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-02-05 |
1174018162 | Priscilla Hurt | Social Worker | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2018-06-22 |
1396249819 | Jennifer L Allmon | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr, Charleston, SC 29406 | 2018-03-20 |
1609395458 | Mason Patrick Weisgarber | Physician Assistant | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2017-09-13 |
1437676707 | Avery Shawen | Pharmacist | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2017-08-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
Find all providers in zip 29406 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881174936 | Jaclyn Sudol | Nurse Practitioner | 2946 Ashley River Rd, Charleston, SC 29414-7049 | 2018-08-17 |
1427437821 | Wv Phs LLC | Nurse Practitioner | 400 Patterson Ln, Charleston, WV 25311-1570 | 2015-05-19 |
1417933193 | Emmie Elizabeth Steadman | Nurse Practitioner | 96 Jonathan Lucas St, Suite 424, Charleston, SC 29425-8900 | 2005-12-15 |
1285231340 | Bree Romecki | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-10-02 |
1558971390 | Auryelle Ascue | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-06 |
1356973820 | Jason Foster | Nurse Practitioner | 1137 Sam Rittenberg Blvd, Charleston, SC 29407-3360 | 2020-02-12 |
1841830940 | Daniel Christopher Michalski | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-5098 | 2020-01-07 |
1932747748 | Chelsey A D Massey | Nurse Practitioner | 316 Calhoun St, Charleston, SC 29401-1113 | 2019-12-12 |
1417593526 | Caitlin Marie Baker | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2019-11-24 |
1053957696 | Lynn Jarrett | Nurse Practitioner | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2019-11-19 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 29406 |
Please comment or provide details below to improve the information on JACQUELYN SUZETTE AMMONS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.