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Individual

CHRYSTE LASHON MIDDLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, CCM

Contact information

Practice address
312 GLEN ARBOR LOOP, IRMO, SC 29063-8881
(770) 856-1780
(855) 222-0084
Mailing address
312 GLEN ARBOR LOOP, IRMO, SC 29063-8881
(770) 856-1780
(855) 222-0084

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
223162
SC
163WG0000X
General Practice Registered Nurse
223162
SC

Other

Enumeration date
01/04/2021
Last updated
01/04/2021
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