Wilt, Michelle L.

Wilt, Michelle L. is an individual health care provider with primary practice located at 809 82Nd Pkwy , Myrtle Beach SC 29572-4607. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Wilt, Michelle L. can be contacted via phone (843) 692-1062.

Contact Information

Primary practice address
809 82Nd Pkwy Myrtle Beach SC 29572-4607
Phone: (843) 692-1062
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R76081 South Carolina

Profile Details

NPI number 1144270232
LBN Legal business name Wilt, Michelle L.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Feb 6th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144270232 NPPES
South Carolina MEDICAID AN1223

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