Individual
MRS. PRUDENCE MELINDA OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1120 GLENNS BAY RD, SURFSIDE BEACH, SC 29575-4757
(843) 215-5492
(843) 215-5512
Mailing address
1552 HEATHMUIR DR, MYRTLE BEACH, SC 29575-5370
(843) 995-1136
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
271
SC
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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