Individual
MRS. SHAWNIE RENEE PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C
Contact information
Practice address
1012 MARKET ST STE 301, FORT MILL, SC 29708-6537
(803) 881-9990
Mailing address
1824 PEDEN BRIDGE RD, CHESTER, SC 29706-3720
(803) 412-6696
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01813
NC
363A00000X
Physician Assistant
PA19382
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740477207
—
NC
Enumeration date
09/28/2007
Last updated
07/08/2019
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