MRS. JENA W. NICKLES PA NPI 1821399106

NPI Information

  • NPI: 1821399106
  • Provider Name: MRS. JENA W. NICKLES, PA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: 180 WINGO WAY
    SUITE 301
    MT PLEASANT, SC
    ZIP 29464
  • Phone: (843) 884-0302

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NPI Details

MRS. Jena W. Nickles, PA is a surgical physician assistant in Mt Pleasant, SC. MRS. Jena W. Nickles, PA NPI is 1821399106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

180 WINGO WAY
SUITE 301
MT PLEASANT, SC
ZIP 29464-810
Phone: (843) 884-0302
Fax: (843) 849-9308

The enumeration date for this NPI number is 11/3/2010 and was last updated on 1/24/2017.

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
1363AS0400XPhysician AssistantSurgical1585SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1AA59309223MEDICARE PINSOUTH CAROLINA
21076PAMEDICAIDSOUTH CAROLINA

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: 11/21/2025

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