Healthcare Provider Details

I. General information

NPI: 1093069817
Provider Name (Legal Business Name): CHRISTINE WRIGHT RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 WISE RD
CONWAY SC
29526-5521
US

IV. Provider business mailing address

2404 WISE RD
CONWAY SC
29526-5521
US

V. Phone/Fax

Practice location:
  • Phone: 843-365-8884
  • Fax: 843-365-6685
Mailing address:
  • Phone: 843-365-8884
  • Fax: 843-365-6685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberR56373
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR56373
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: