Provider Demographics
NPI:1083498620
Name:HUNSUCKER, JESSICA HODGES
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:HODGES
Last Name:HUNSUCKER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 WHITETAIL CT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-8029
Mailing Address - Country:US
Mailing Address - Phone:843-473-2271
Mailing Address - Fax:
Practice Address - Street 1:3600 SEA MOUNTAIN HWY STE B
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8161
Practice Address - Country:US
Practice Address - Phone:843-366-3920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC245271163W00000X
SC29931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse