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NPI 1013471101

NPI 1013471101 : ALYSSA W URSINI FNP : WALTERBORO, SC

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General NPI Number Information
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    NPI Number           |    1013471101
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    Entity Type          |    Individual 
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    Provider Name        |    ALYSSA W URSINI FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/23/2019
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    Last Update Date     |    01/23/2019
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Provider Practice Location Address
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    Address Line         |    1515 BELLS HWY 
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    City                 |    WALTERBORO
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    State                |    SC
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    Zip                  |    29488-2517
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    Country              |    US
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    Telephone            |    843-538-6240
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    374 SUMMERS DR 
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    City                 |    SUMMERVILLE
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    State                |    SC
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    Zip                  |    29485-7450
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    Country              |    US
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    Telephone            |    860-967-7022
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    22549
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    License Number State |    SC
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