1316991235 NPI number — MRS. CHRISTINE MILLIGAN LEWIS APRN

Table of content: MRS. CHRISTINE MILLIGAN LEWIS APRN (NPI 1316991235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316991235 NPI number — MRS. CHRISTINE MILLIGAN LEWIS APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEWIS
Provider First Name:
CHRISTINE
Provider Middle Name:
MILLIGAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLIGAN-LEWIS
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316991235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1624 MAIN STREET
Provider Second Line Business Mailing Address:
DBA LTC HEALTH SOLUTIONS
Provider Business Mailing Address City Name:
BEAUFORT
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29201-2818
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-726-2350
Provider Business Mailing Address Fax Number:
803-753-9102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 TODD DRIVE
Provider Second Line Business Practice Location Address:
DBA LTC HEALTH SOLUTIONS
Provider Business Practice Location Address City Name:
BEAUFORT
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29902-6113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-491-0909
Provider Business Practice Location Address Fax Number:
843-353-2581
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APN1697 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NP0705 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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