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General NPI Number Information
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NPI Number | 1033724323
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Entity Type | Organization
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Legal Business Name | OCEANHORSE HEALTH AND WELLNESS CLINIC
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Dates
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Enumeration Date | 09/13/2020
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 4212 CORAL PARK DR OFC
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City | BRUNSWICK
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State | GA
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Zip | 31520-3016
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Country | US
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Telephone | 912-275-8165
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Fax | 912-289-9450
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Provider Business Mailing Address
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Address Line | 4212 CORAL PARK DR
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City | BRUNSWICK
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State | GA
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Zip | 31520-3016
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Country | US
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Telephone | 912-275-8165
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Fax | 912-289-9450
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | CATHY SLAY-CHIPP
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Credential | NURSE PRACTITIONER
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Telephone | 912-230-1556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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