Individual provider · Type 1 NPI

Liston Alexander Weatherly Jr., APRN

Nurse Practitioner · Hartsville, SC

NPI number 1912413832 Active

Practice location

1268 S 4th St
Hartsville, SC 29550-0703

Call (803) 484-5317 Map

Mailing address

PO Box 1090
Hartsville, SC 29551-1090

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X21363 (SC)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1912413832

Liston Alexander Weatherly Jr., APRN's National Provider Identifier is 1912413832, issued on Dec 15, 2017. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Hartsville, SC. The record was last updated on Sep 22, 2021.