Provider Demographics
NPI:1679821540
Name:HUSK, NICOLE DAWN
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:DAWN
Last Name:HUSK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5601
Mailing Address - Country:US
Mailing Address - Phone:843-870-3212
Mailing Address - Fax:
Practice Address - Street 1:3036 S SHORE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5601
Practice Address - Country:US
Practice Address - Phone:843-870-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic