Provider Demographics
NPI:1316991235
Name:LEWIS, CHRISTINE MILLIGAN (APRN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MILLIGAN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:MILLIGAN-LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1624 MAIN STREET
Mailing Address - Street 2:DBA LTC HEALTH SOLUTIONS
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2818
Mailing Address - Country:US
Mailing Address - Phone:803-726-2350
Mailing Address - Fax:803-753-9102
Practice Address - Street 1:11 TODD DRIVE
Practice Address - Street 2:DBA LTC HEALTH SOLUTIONS
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6113
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:843-353-2581
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN1697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0705Medicaid
P35747Medicare UPIN