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1821399106
JENA W. NICKLES
MT PLEASANT, SC
NPI
1821399106
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Former Name
JENA M. WEAVER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: SC 1585)
Enumeration Date
2010-11-03
Last Update Date
2017-01-24
Business Address
Mrs. JENA W. NICKLES PA
180 WINGO WAY SUITE 301
MT PLEASANT, SC 29464-1810
Phone number: 843-884-0302
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Mailing Address
Mrs. JENA W. NICKLES PA
PO BOX 751649
CHARLOTTE, NC 28275-1649
Phone number: 843-789-1620
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