Healthcare Provider Details

I. General information

NPI: 1457786246
Provider Name (Legal Business Name): CHRISTY PAULINE NELSON AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BILL FRIES DR BLDG F
HILTON HEAD SC
29926-2731
US

IV. Provider business mailing address

35 BILL FRIES DR BLDG F
HILTON HEAD SC
29926-2731
US

V. Phone/Fax

Practice location:
  • Phone: 843-681-6668
  • Fax: 843-681-3295
Mailing address:
  • Phone: 843-681-6668
  • Fax: 843-681-3295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number27940
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60404986
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP60404986
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: