Provider Demographics
NPI:1679642870
Name:HOUSER, CHRISTINE N (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:N
Last Name:HOUSER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:E
Other - Last Name:NANGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:27 GAMECOCK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3398
Mailing Address - Country:US
Mailing Address - Phone:843-769-8215
Mailing Address - Fax:803-753-9102
Practice Address - Street 1:134 JUNGLE RD
Practice Address - Street 2:
Practice Address - City:EDISTO ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29438-3005
Practice Address - Country:US
Practice Address - Phone:843-897-7757
Practice Address - Fax:843-897-7877
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2871363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1041Medicaid
SC2871OtherAPRN
SC2871OtherAPRN
SCQ72606Medicare UPIN