Doctor Name: | MRS. ANGELA PACE STILES |
NPI Number: | 1023280583 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 5004057 |
Business Practice Address: | 3248 Holmestown Rd Unit C1 Myrtle Beach, SC - 295887492 |
Business Phone Number: | 8436684565 |
Business Fax Number: | 8436684572 |
Mailing Address: | 3248 Holmestown Rd, Unit C1 MYRTLE BEACH |
State: | SC |
Postal Code: | 295887492 |
Phone Number: | 8436684565 |
Fax Number: | 8436684572 |
NPI Enumeration Date: | 03/25/2008 |
NPI Last Update Date: | 07/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5004057 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |