Provider Demographics
NPI:1497157911
Name:ADKINS, SHERLONDA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERLONDA
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 W LIBERTY PARK CIR
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-4027
Mailing Address - Country:US
Mailing Address - Phone:843-608-8798
Mailing Address - Fax:
Practice Address - Street 1:2070 NORTHBROOK BLVD STE B1
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9325
Practice Address - Country:US
Practice Address - Phone:843-608-8798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI091363A00000X
SC2188363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant