Basic Information
| Provider Information | |||||||||
| NPI: | 1770804080 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MESSERVY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | MAW | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 MICHELIN RD | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296056131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644581376 | ||||||||
| FaxNumber: | 8644581382 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 MICHELIN RD | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644581376 | ||||||||
| FaxNumber: | 8644581382 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2010 | ||||||||
| LastUpdateDate: | 07/27/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F4193 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.