Provider Demographics
NPI:1407283229
Name:PNIEWSKI, MELANIE KITCHINGS (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:KITCHINGS
Last Name:PNIEWSKI
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13955
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29422-3955
Mailing Address - Country:US
Mailing Address - Phone:803-508-7651
Mailing Address - Fax:803-508-7655
Practice Address - Street 1:215 TOWN CREEK RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5843
Practice Address - Country:US
Practice Address - Phone:803-508-7651
Practice Address - Fax:803-508-7655
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165910363LP0200X
SC18600364SP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3157Medicaid