MISS SHYEASHA TANIKA WILSON APRN-BC PMHNP-BC NPI 1073167185

NPI Information

  • NPI: 1073167185
  • Provider Name: MISS SHYEASHA TANIKA WILSON, APRN-BC, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1911 GADSDEN ST STE 204
    COLUMBIA, SC
    ZIP 29201
  • Phone: (803) 254-9767

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NPI Details

MISS Shyeasha Tanika Wilson, APRN-BC, PMHNP-BC is a psychiatric/mental health nurse practitioner in Columbia, SC. MISS Shyeasha Tanika Wilson, APRN-BC, PMHNP-BC NPI is 1073167185. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1911 GADSDEN ST STE 204
COLUMBIA, SC
ZIP 29201-400
Phone: (803) 254-9767

The NPI 1073167185 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/26/2019 and was last updated on 6/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WP0808XRegistered NursePsychiatric/Mental Health104416SOUTH CAROLINANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health23783SOUTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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