Individual
MANDA RAE WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
380 2ND AVE S, MURRELLS INLET, SC 29576-8153
(717) 818-9912
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23454
SC
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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