Provider Demographics
NPI:1396413092
Name:CHAMPION, CHRISTYL LLOPIS
Entity Type:Individual
Prefix:
First Name:CHRISTYL
Middle Name:LLOPIS
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 RIVIERA PL
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7302
Mailing Address - Country:US
Mailing Address - Phone:803-517-3941
Mailing Address - Fax:
Practice Address - Street 1:502 RIVIERA PL
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7302
Practice Address - Country:US
Practice Address - Phone:803-517-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily