Individual
SHAWNTOYA WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
342 W MAIN ST, KINGSTREE, SC 29556-3235
(843) 355-3621
(843) 355-3624
Mailing address
342 W MAIN ST, KINGSTREE, SC 29556-3235
(843) 355-3621
(843) 355-3624
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
43195
SC
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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