Individual
MS. WANDA CAWTHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1211 48TH AVENUE N, MYRTLE BEACH, SC 29577
(843) 449-1000
(843) 449-1009
Mailing address
1211 48TH AVENUE N, MYRTLE BEACH, SC 29577
(843) 449-1000
(843) 449-1009
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A17675
SC
363LA2200X
Adult Health Nurse Practitioner
RN072630
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000498825D
—
GA
Enumeration date
07/10/2006
Last updated
05/12/2023
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