Individual
ASHLEY NICHOLE MCCLENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1847 S LAKE DR, LEXINGTON, SC 29073-7759
(803) 356-8998
(803) 356-8999
Mailing address
1847 S LAKE DR, LEXINGTON, SC 29073-7759
(803) 356-8998
(803) 356-8999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2502
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000PA
—
SC
01
—
423828
MEDICARE RURAL
SC
01
—
428926
MEDICARE RURAL
SC
05
—
PC4116
—
SC
05
—
RHC020
—
SC
05
—
RHC151
—
SC
Enumeration date
02/19/2016
Last updated
10/22/2018
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