Provider Demographics
NPI:1699409409
Name:MCGEE, WILLENA NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:WILLENA
Middle Name:NICOLE
Last Name:MCGEE
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 1:400 DUKES HILL RD # TD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-9069
Mailing Address - Country:US
Mailing Address - Phone:843-246-3107
Mailing Address - Fax:
Practice Address - Street 1:400 DUKES HILL RD # TD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-9069
Practice Address - Country:US
Practice Address - Phone:843-246-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC343900000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)