Provider Demographics
NPI:1518784412
Name:DENT, JENNIFER KLOSTERMAN (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KLOSTERMAN
Last Name:DENT
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 THORNHILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1836
Mailing Address - Country:US
Mailing Address - Phone:803-422-8137
Mailing Address - Fax:
Practice Address - Street 1:1333 TAYLOR ST STE 2D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2945
Practice Address - Country:US
Practice Address - Phone:803-438-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily