Individual
MRS. LARA J ALICEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2375 BAKER HOSPITAL BLVD, NORTH CHARLESTON, SC 29405-8233
(843) 744-2750
Mailing address
2244 ASHLEY CROSSING DR UNIT 112, CHARLESTON, SC 29414-6082
(951) 445-8667
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22569
SC
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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