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Individual

CHRISTINA NICHOLE WEATHERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
Mailing address
11185 PEE DEE RD S, GALIVANTS FERRY, SC 29544-8941
(843) 877-9353

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18010
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1184113
WELLCARE
SC
01
1659611903
CONSUMERS CHOICE
SC
01
30233134
SELECT HEALTH
SC
01
3670218
UNITED HEALTHCARE
SC
01
4166115
AETNA
SC
01
80058760
SELECT HEALTH
SC
05
NP2400
SC
01
P01553934
RR MEDICARE
SC
01
SC0985B865
MEDICARE
SC
Enumeration date
02/25/2013
Last updated
04/25/2016
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