Provider Demographics
NPI:1043619414
Name:FORD, CAROLINE PIKE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:PIKE
Last Name:FORD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:WICKLIFFE
Other - Last Name:PIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-0280
Mailing Address - Country:US
Mailing Address - Phone:843-652-4800
Mailing Address - Fax:843-357-4783
Practice Address - Street 1:4057 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5032
Practice Address - Country:US
Practice Address - Phone:843-652-4800
Practice Address - Fax:843-357-4783
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21677363LF0000X
COAPN.0991388-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily