Provider Demographics
NPI:1528728912
Name:LOZANO, JENNIFER REAL (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:REAL
Last Name:LOZANO
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 1:1018 ANNELLE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6364
Mailing Address - Country:US
Mailing Address - Phone:843-468-0993
Mailing Address - Fax:
Practice Address - Street 1:804 HUNTINGTON PLAZA
Practice Address - Street 2:2ND LOOP RD
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-2827
Practice Address - Country:US
Practice Address - Phone:843-404-4669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25476363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care