Provider Demographics
NPI:1447909486
Name:CONVENIENT HEALTH AND WELLNESS VIRTUAL CARE
Entity type:Organization
Organization Name:CONVENIENT HEALTH AND WELLNESS VIRTUAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMP
Authorized Official - Prefix:
Authorized Official - First Name:LATOHSA
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:843-687-0214
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-0237
Mailing Address - Country:US
Mailing Address - Phone:843-687-0214
Mailing Address - Fax:
Practice Address - Street 1:678 MOORE ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-4273
Practice Address - Country:US
Practice Address - Phone:843-687-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Single Specialty