Abundant Grace Wellness, LLC
NPI 1962092114ActiveOrganization· Nurse Practitioner, Adult Health· Charleston, SC
Nurse Practitioner, Adult Health in Charleston, South Carolina, registered in NPPES in January 2021. The authorized official on file is Gloria Katherine Wilson, APRN, Authorized Official/Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962092114 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 21, 2021 |
| Last updated in NPPES | Sep 14, 2023 |
| Certified by provider | Jan 21, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Adult Health Primary | 363LA2200X | — | — |
| Nurse Practitioner, Community Health | 363LC1500X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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