JACLYN SUDOL (NPI# 1881174936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881174936 |
| Entity Type | Individual |
| Full Name | JACLYN SUDOL |
| Credential | ACNPC-AG, FNP-BC |
| Practice Address |
2946 Ashley River Rd Charleston SC 29414-7049 |
| Practice Telephone | 4196312607 |
| Mailing Telephone | 4196312607 |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2019-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
22048 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
22048 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2946 ASHLEY RIVER RD |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414-7049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1538710116 | Matthew Wayne Faust | Nurse Practitioner | 316 Calhoun St, Charleston, SC 29401-1113 | 2019-09-24 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
Please comment or provide details below to improve the information on JACLYN SUDOL.
| 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.