Individual
DEBRA WILDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
1931 INDUSTRIAL PARK RD, CONWAY, SC 29526-5482
(803) 849-5359
Mailing address
111 ROCKDALE ST, MYRTLE BEACH, SC 29579-6868
(330) 340-3412
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
228449
SC
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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