Healthcare Provider Details

I. General information

NPI: 1538792593
Provider Name (Legal Business Name): WHITNEY ANNE ELSWICK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 ANCHOR WATCH DR
WADMALAW ISLAND SC
29487-7125
US

IV. Provider business mailing address

2815 ANCHOR WATCH DR
WADMALAW ISLAND SC
29487-7125
US

V. Phone/Fax

Practice location:
  • Phone: 843-901-0740
  • Fax:
Mailing address:
  • Phone: 843-901-0740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number23304
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: