Provider Demographics
NPI:1245800887
Name:CARTER, SHENIKA MITCHELL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHENIKA
Middle Name:MITCHELL
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:SC
Mailing Address - Zip Code:29853-6640
Mailing Address - Country:US
Mailing Address - Phone:803-571-0259
Mailing Address - Fax:
Practice Address - Street 1:154 WREN ST
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-1527
Practice Address - Country:US
Practice Address - Phone:888-222-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-27
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM64380363LF0000X
SC25053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily