Healthcare Provider Details

I. General information

NPI: 1962783696
Provider Name (Legal Business Name): CHRISTIN L AUSTIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 ISLAND PARK DR STE 200
DANIEL ISLAND SC
29492-8112
US

IV. Provider business mailing address

428 TANNER TRL
CHARLESTON SC
29412-8986
US

V. Phone/Fax

Practice location:
  • Phone: 843-856-6402
  • Fax: 843-216-5068
Mailing address:
  • Phone: 843-822-5662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17588
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: