Individual
MRS. STEFANIE LYNN CRETELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
459 N HIGHWAY 52, MONCKS CORNER, SC 29461-3924
(843) 899-3870
(843) 899-3877
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1496
SC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117PA
—
SC
Enumeration date
10/15/2009
Last updated
10/31/2024
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