Individual
MELISSA ANN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 GOER DR STE 201, NORTH CHARLESTON, SC 29406-6500
(843) 554-1029
Mailing address
1507 EAGLE LANDING BLVD, HANAHAN, SC 29410-8583
(843) 330-2960
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
224494
SC
363LF0000X
Family Nurse Practitioner
Primary
21770
SC
Other
Enumeration date
11/19/2017
Last updated
10/02/2018
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