Nickles, Jena W.
Nickles, Jena W. is an individual health care provider with primary practice located at 180 Wingo Way Suite 301, Mt Pleasant SC 29464-1810. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Nickles, Jena W. can be contacted via phone (843) 884-0302.Contact Information
Primary practice address
180 Wingo Way Suite 301
Mt Pleasant SC 29464-1810
Phone: (843) 884-0302
Fax: (843) 849-9308
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 1585 | South Carolina |
Profile Details
| NPI number | 1821399106 |
|---|---|
| LBN Legal business name | Nickles, Jena W. |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2010 |
| Last updated | Jan 24th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821399106 | NPPES |
| South Carolina | MEDICAID | 1076PA |
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