Provider Demographics
NPI:1124253778
Name:O'NEILL, JESSICA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:803-791-2350
Mailing Address - Fax:803-791-2520
Practice Address - Street 1:222 E MEDICAL LN STE 400
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4848
Practice Address - Country:US
Practice Address - Phone:803-794-7511
Practice Address - Fax:803-794-7751
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2024-08-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant