| NPI | 1356951628 |
|---|---|
| Former Legal Business Name | SKYLINE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | CHELSEY DEVER Credentialing Coordinator 843-697-5168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2024-07-18 |