Individual
SHALINI GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1608 MAIN ST, CONWAY, SC 29526-3572
(843) 248-4700
Mailing address
543 ROSINGS DR, SUMMERVILLE, SC 29483-7774
(843) 875-4525
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
209007780
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
3933
SC
Other
Enumeration date
01/03/2010
Last updated
01/03/2010
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