Organization
CHECKUPS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA PACE STILES FNP-BC (LLC MEMBER/NURSE PRACTITIONER)
(843) 349-0160
Entity
Organization
Contact information
Practice address
154B WACCAMAW MEDICAL PARK CT, CONWAY, SC 29526-8965
(843) 349-0160
(843) 349-0161
Mailing address
154B WACCAMAW MEDICAL PARK CT, CONWAY, SC 29526-8965
(843) 349-0160
(843) 349-0161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3491
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5970
—
SC
Enumeration date
05/16/2012
Last updated
10/12/2012
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