Individual provider · Type 1 NPI

Katie Gardner Nickerson, PA-C

Medical Physician Assistant · North Charleston, SC

NPI number 1720358070 Active

Practice location

8740 Rivers Ave
North Charleston, SC 29406-9211

Call (843) 572-5990 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X0010-03197 (NC)
Medical Physician Assistant Primary 363AM0700X2251 (SC)

Medical Physician Assistant: Definition to come...

11 other providers at this address

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About NPI 1720358070

Katie Gardner Nickerson, PA-C's National Provider Identifier is 1720358070, issued on Jan 4, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in North Charleston, SC. The record was last updated on Mar 9, 2017.