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General NPI Number Information
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NPI Number | 1497578660
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Entity Type | Organization
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Legal Business Name | COASTAL REGIONAL HEALTH & WELLNESS, PLLC
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 15539 NC HWY 55
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City | BAYBORO
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State | NC
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Zip | 28515
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Country | US
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Telephone | 828-446-6241
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 98
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City | GRANTSBORO
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State | NC
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Zip | 28529-0098
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. AMANDA M. CLINE-GRANT
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Credential | DC, FNP-BC
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Telephone | 252-999-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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