Individual
MAKENNA WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
25 COURTENAY DR, CHARLESTON, SC 29425-6404
(843) 792-2300
Mailing address
7736 FARR ST APT 908, DANIEL ISLAND, SC 29492-6404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5522
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/31/2024
Last updated
10/08/2024
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