Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1497578660 |
| LBN Legal business name | COASTAL REGIONAL HEALTH & WELLNESS, PLLC |
| Authorized official | AMANDA CLINE-GRANT - (OFFICER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/05/2024 |
| Last updated | 02/19/2025 - More than a year ago |
| Identifiers | n/a |
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