Individual
MISS NIKAELA ROSE LAROSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(860) 919-3696
Mailing address
225 RICHARDSON ST APT 4314, CAYCE, SC 29033-4439
(860) 919-3696
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
255450
SC
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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