Individual
MS. ALICE M MAZZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9304 MEDICAL PLAZA DR STE D, CHARLESTON, SC 29406-9143
(843) 863-5600
(843) 553-2123
Mailing address
9304 MEDICAL PLAZA DR STE D, CHARLESTON, SC 29406-9143
(843) 863-5600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22064
SC
363LA2200X
Adult Health Nurse Practitioner
22064
SC
363LA2200X
Adult Health Nurse Practitioner
F302704-1
NY
Other
Enumeration date
04/23/2013
Last updated
01/27/2022
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