Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 37246 | SC |
NPI | 1053654053 |
---|---|
Provider Name | Dr. Jessica Scheel Connett |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 14/01/2019 |