Individual
MRS. PHOEBE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
776 DANIEL ELLIS DR, SUITE 2 BUILDING A, CHARLESTON, SC 29412-3094
(843) 795-8100
(843) 573-2534
Mailing address
1952 LONG GROVE DR, SUITE 202, MT PLEASANT, SC 29464-7579
(843) 795-8100
(843) 573-2534
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
18030
SC
Other
Enumeration date
09/25/2012
Last updated
10/08/2014
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