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Individual

NYASIA MIKELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2076 GREEN PARK AVE, CHARLESTON, SC 29414-6018
(843) 303-6361
Mailing address
78 FOLLY ROAD BLVD STE B9, CHARLESTON, SC 29407-7551
(843) 303-6361

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
559428
SC

Other

Enumeration date
12/20/2024
Last updated
12/20/2024
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