person
Jack Allan Stauffer, FNP
Family Nurse Practitioner in Summerville, South Carolina
NPI 1396703740

Jack Allan Stauffer is a Family Nurse Practitioner based in Summerville, SC and is specialized in Family. Jack Allan Stauffer practices in Summerville, SC and has the professional credentials of FNP. The NPI Number for Jack Allan Stauffer is 1396703740 and holds a License No. 629 (South Carolina).

The current practice location address for Jack Allan Stauffer is 435 N Cedar St, Summerville, SC and can be reached out via phone at 843-873-1592 and via fax at 843-820-3373. You can also correspond with Jack Allan Stauffer through the mailing address at 201 SIGMA DR, SUMMERVILLE, SC - 29486-7715 (mailing address contact number: 843-554-8312).

Location: 435 N Cedar St, Summerville, SC, 29486-7715
person
Provider Profile Details
NPI Number
1396703740
Provider Name
Jack Allan Stauffer
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
435 N Cedar St, Summerville, SC, 29486-7715
Phone Number
843-873-1592
Fax Number
843-820-3373
Provider Enumeration Date
05/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00851396 01 SC RR MEDICARE PTAN
NP0021 05 SC
institution
Provider Business Practice Location Address Details
Address
435 N Cedar St
City
State
Zip
29483-6407
Phone Number
843-873-1592
Fax Number
843-820-3373
person
Provider Business Mailing Address Details
Address
435 N Cedar St
City
State
Zip
29483-6407
Phone Number
843-873-1592
Fax Number
843-820-3373
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
629 (South Carolina)
Definition
Definition to come...
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