Organization
ABUNDANT GRACE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA KATHERINE WILSON APRN (AUTHORIZED OFFICIAL/PROVIDER)
(843) 801-0861
Entity
Organization
Contact information
Practice address
2045 MAYBANK HWY, CHARLESTON, SC 29412
(843) 801-0861
(843) 768-1473
Mailing address
2414 RACQUET CLUB DRIVE, JOHNS ISLAND, SC 29455-6300
(843) 801-0861
(843) 768-1473
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18678
STATE LICENSE
SC
Enumeration date
01/21/2021
Last updated
09/14/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us