Individual
MARY ELISHEVA WILCHANOVSKY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
APRN, WHNP
Contact information
Practice address
4050 BRIDGE VIEW DR, SUITE 600, CHARLESTON, SC 29405-7488
(843) 746-3800
Mailing address
516 ARLINGTON DR, A-3, CHARLESTON, SC 29414-5010
(843) 571-1123
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
WH 870
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WH 870
APRN LICENSE NUMBER
SC
Enumeration date
08/09/2005
Last updated
07/08/2007
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