Healthcare Provider Details

I. General information

NPI: 1790019602
Provider Name (Legal Business Name): ANNA WELLS-SHARP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 BLUFFTON RD STE 101&G102
BLUFFTON SC
29910-6221
US

IV. Provider business mailing address

181 BLUFFTON RD # G101G102
BLUFFTON SC
29910-6221
US

V. Phone/Fax

Practice location:
  • Phone: 843-757-5400
  • Fax: 843-757-2240
Mailing address:
  • Phone: 843-757-5400
  • Fax: 843-757-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1514
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: