Provider Demographics
NPI:1992057285
Name:PEELMAN, JENNIFER E (PA-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:E
Last Name:PEELMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:370 S HERLONG AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1160
Mailing Address - Country:US
Mailing Address - Phone:803-980-5864
Mailing Address - Fax:803-980-5817
Practice Address - Street 1:370 S HERLONG AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1160
Practice Address - Country:US
Practice Address - Phone:803-980-5864
Practice Address - Fax:803-980-5817
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC1814363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical