Individual
LISA HALVORSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
68 POPLAR ST, CHARLESTON, SC 29403-3733
(508) 450-6379
Mailing address
68 POPLAR ST, CHARLESTON, SC 29403-3733
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2026003609
SC
Other
Enumeration date
07/24/2026
Last updated
07/25/2026
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