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1285291187
DANIELLE WIESE PROX
CHARLESTON, SC
NPI
1285291187
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: SC 22266)
Enumeration Date
2019-05-26
Last Update Date
2019-05-26
Business Address
DANIELLE WIESE PROX
171 ASHLEY AVE
CHARLESTON, SC 29425-8908
Phone number: 843-792-1414
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Mailing Address
DANIELLE WIESE PROX
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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