Individual
NIMESHIKA WASANA YATIYAWELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
317 SAINT FRANCIS DR STE 330, GREENVILLE, SC 29601-3914
(864) 335-7555
(864) 459-0877
Mailing address
PO BOX 631341, CINCINNATI, OH 45263-1341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4544
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/13/2022
Last updated
01/29/2024
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