Organization
COASTAL CAROLINA UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JILL MICHAEL APRN (NIRSE PRACTITIONER)
(843) 349-6543
Entity
Organization
Contact information
Practice address
204 UNIVERSITY BLVD, CONWAY, SC 29526-8834
(843) 649-6543
Mailing address
204 UNIVERSITY BLVD, CONWAY, SC 29526-8834
(843) 649-6543
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3684
SC
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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