Most Relevant Information
Provider Data
| NPI Number: | 1003429259 |
| Provider Name: | MARY TAYLOR BRITT JACKSON FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 24213 |
Most Important Dates
| Enumeration Date: | 08/27/2020 |
| Last Updated: | 07/17/2024 |
Provider Practice Location
8121 ROURK ST
MYRTLE BEACH
SC
295724128
Practice Location Phone/Fax
| Phone: | 8436925000 |
| Fax: | 8436925010 |
Provider Mailing Location
8121 ROURK ST
MYRTLE BEACH
SC
295724128
Provider Mailing Phone/Fax
| Phone: | 8436925000 |
| Fax: | 8436925010 |