| Jenni Lisa Hackenberg, | |
|
1709 Old Trolley Rd, Summerville, SC 29485-8276 | |
| (843) 873-2225 | |
| Not Available |
| Full Name | Jenni Lisa Hackenberg |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 1709 Old Trolley Rd, Summerville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235709395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 25116 (South Carolina) | Primary |
| Entity Name | Rejuvinix LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710409529 PECOS PAC ID: 0345513537 Enrollment ID: O20170911001504 |
| Mailing Address | Practice Location Address |
|---|---|
| Jenni Lisa Hackenberg, 621 Van Buren Dr, Summerville, SC 29486-0405 Ph: (803) 522-4570 | Jenni Lisa Hackenberg, 1709 Old Trolley Rd, Summerville, SC 29485-8276 Ph: (843) 873-2225 |
Nicholas Arthur Hathaway, FNP, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 213 W 4th St N, Summerville, SC 29483 Phone: 843-873-0681 |
Marie Davis Rataj, ANP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 92 Springview Lane, South Carolina Sleep Medicine, Summerville, SC 29485 Phone: 843-871-4006 Fax: 843-871-4074 |
Mrs. Caroline M Yerich, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 809 N Cedar St, Summerville, SC 29483 Phone: 843-871-9440 Fax: 843-871-5932 |
Kristina M Dibartolo, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 90 Springview Ln # A, Summerville, SC 29485 Phone: 843-832-9113 Fax: 843-832-9114 |
Alison Rose Gardella, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Callen Blvd Ste 300, Summerville, SC 29486 Phone: 843-789-1800 |
Jody Kay Smith, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 89 Old Trolley Rd Ste 200, Summerville, SC 29485 Phone: 737-226-6740 |
Katherine Ellis, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2016 1st Ave, Summerville, SC 29486 Phone: 843-432-3109 |