Provider Demographics
NPI:1629379839
Name:WOMENS HEALTH PARTNERS
Entity Type:Organization
Organization Name:WOMENS HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-832-5096
Mailing Address - Street 1:75 SPRINGVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8154
Mailing Address - Country:US
Mailing Address - Phone:843-832-5096
Mailing Address - Fax:843-832-5115
Practice Address - Street 1:75 SPRINGVIEW LN
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8154
Practice Address - Country:US
Practice Address - Phone:843-832-5096
Practice Address - Fax:843-832-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1595TL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty