Jacqueline Pryor
Individual provider Active NPI Home Health Aide · Huger, SC
NPI 1104675776 · NPPES record last updated May 16, 2024
Key facts
- NPI
- 1104675776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- License
- 85-1189288 (SC)
- Practice address
- 120 Mudhole LN
Huger, SC 29450-9503 - Phone
- (843) 818-9366
- NPI assigned
- May 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85-1189288 | SC | MD | Home Health Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 85-1189288 | SC | Yes |
Addresses
Primary practice location
120 Mudhole LN
Huger, SC 29450-9503
Mailing address
120 Mudhole LN
Huger, SC 29450-9503
Phone (843) 818-9366
Other providers in Huger, SC
- Margaretta C. Grimm
- Kristi Ann Jones
- Rodney Darrell Lockwood
- Eunice Price Moore
- Palmetto Restorative Therapy
- Megan Kathleen Shanahan
- Andrew Fred Tyler
- Gretchen Tyler
All providers in Huger, SC · Home Health Aide in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.