Individual
MRS. CHINISE KAYANNA CLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-7109
(843) 792-1414
Mailing address
67 PRESIDENT ST, CHARLESTON, SC 29425-5712
(803) 990-2120
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24027
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24027
STATE LICENSE
SC
05
—
NP7081
—
SC
01
—
SCI772
MEDICARE
SC
Enumeration date
06/26/2020
Last updated
03/01/2024
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