Individual
MRS. MELANIE K WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7763 NORTHSIDE DRIVE, NORTH CHARLESTON, SC 29420
(843) 818-1496
Mailing address
7763 NORTHSIDE DRIVE, NORTH CHARLESTON, SC 29420
(843) 818-1496
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN16853
SC
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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