Healthcare Provider Details

I. General information

NPI: 1013843143
Provider Name (Legal Business Name): CHRISTOS INTEGRATED HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

994 YELLOWSTONE DR
FLORENCE SC
29505-6501
US

IV. Provider business mailing address

994 YELLOWSTONE DR
FLORENCE SC
29505-6501
US

V. Phone/Fax

Practice location:
  • Phone: 843-621-8796
  • Fax:
Mailing address:
  • Phone: 843-621-8796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEANNA HARLEY
Title or Position: MEMBER/OWNER
Credential: FNP, PMHNP
Phone: 843-621-8796