Provider Demographics
NPI:1336257120
Name:SALLENGER, JENA E (APRN)
Entity type:Individual
Prefix:MRS
First Name:JENA
Middle Name:E
Last Name:SALLENGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5128
Mailing Address - Country:US
Mailing Address - Phone:843-415-1794
Mailing Address - Fax:866-659-6888
Practice Address - Street 1:514 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2552
Practice Address - Country:US
Practice Address - Phone:843-292-5461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1588363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPENDINGMedicare ID - Type UnspecifiedNURSE PRACTITIONER