Individual
SHANA YALA WABIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
151A RUTLEDGE AVE, CHARLESTON, SC 29425-8903
(704) 807-2601
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-15161
NC
Other
Enumeration date
12/18/2024
Last updated
12/29/2025
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