Provider Demographics
NPI:1962783696
Name:AUSTIN, CHRISTIN L (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:L
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 TANNER TRL
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8986
Mailing Address - Country:US
Mailing Address - Phone:843-822-5662
Mailing Address - Fax:
Practice Address - Street 1:899 ISLAND PARK DR
Practice Address - Street 2:STE 200
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8112
Practice Address - Country:US
Practice Address - Phone:843-856-6402
Practice Address - Fax:843-216-5068
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1904Medicaid
SCP01173502OtherRR-MEDICARE
SCAA77637126Medicare PIN
SCAA7763AMedicare PIN