Individual
MELISSA COSTANTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4612 OLEANDER DRIVE UNIT 102, MYRTLE BEACH, SC 29577-2957
(843) 945-8117
Mailing address
4612 OLEANDER DRIVE UNIT 102, MYRTLE BEACH, SC 29577-4346
(843) 945-8117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23719
SC
363LF0000X
Family Nurse Practitioner
Primary
23719
SC
Other
Enumeration date
02/27/2020
Last updated
11/04/2020
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