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Individual

LINDSEY ELIZABETH DELOACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
19447
SC
363L00000X
Nurse Practitioner
R880074
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
19447
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07786282
MS
Enumeration date
02/18/2014
Last updated
03/02/2022
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