Provider Demographics
NPI:1861087736
Name:HYDE, JENNIFER ANNE (PNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:HYDE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Mailing Address - Street 1:1871 SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4726
Mailing Address - Country:US
Mailing Address - Phone:843-766-6308
Mailing Address - Fax:803-254-3678
Practice Address - Street 1:105 SPRINGHALL DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5370
Practice Address - Country:US
Practice Address - Phone:843-766-6308
Practice Address - Fax:866-533-4473
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2022-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC24451363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics