Provider Demographics
NPI:1033570148
Name:PINCKNEY, SHAVONNA PRESSLEY (RN)
Entity Type:Individual
Prefix:
First Name:SHAVONNA
Middle Name:PRESSLEY
Last Name:PINCKNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 SHIPLEY ST
Mailing Address - Street 2:APT. 538
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4144
Mailing Address - Country:US
Mailing Address - Phone:843-810-3483
Mailing Address - Fax:
Practice Address - Street 1:106 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3007
Practice Address - Country:US
Practice Address - Phone:843-572-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC211863163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse