Individual
MARY NERISSA VAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1204 E CHEVES ST, FLORENCE, SC 29506-2710
(843) 673-0122
(843) 661-6400
Mailing address
1204 E CHEVES ST, FLORENCE, SC 29506-2710
(843) 673-0122
(843) 661-6400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041400926
IL
363LF0000X
Family Nurse Practitioner
209014924
IL
363LF0000X
Family Nurse Practitioner
Primary
22829
SC
Other
Enumeration date
06/24/2016
Last updated
10/30/2023
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