Provider Demographics
NPI:1386447779
Name:PRIDDY, JAIME (RN)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:PRIDDY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 PADDLE BOAT WAY
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9268
Mailing Address - Country:US
Mailing Address - Phone:843-214-8621
Mailing Address - Fax:
Practice Address - Street 1:870 WALT MILLER ST STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2969
Practice Address - Country:US
Practice Address - Phone:843-509-2851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC248025163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse