| NPI | 1255009163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BROWN Practice Administrator 843-977-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2023-08-16 |