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Organization
ATHENA CONSULTING LLC
Active
Organization
ATHENA CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER STOUT (MANAGER)
(337) 315-7927
Entity
Organization
Contact information
Practice address
3842 LEEDS AVE UNIT C, NORTH CHARLESTON, SC 29405-7460
(843) 747-6634
Mailing address
3842 LEEDS AVE UNIT C, NORTH CHARLESTON, SC 29405-7460
(843) 747-6634
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
NULL
163WW0000X
Wound Care Registered Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/15/2024
Last updated
11/03/2025
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