Provider Demographics
NPI:1295347391
Name:WILKINS, KAILEY MICHELE (PHARMD)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:MICHELE
Last Name:WILKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 LAW LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-9558
Mailing Address - Country:US
Mailing Address - Phone:843-480-1105
Mailing Address - Fax:
Practice Address - Street 1:1952 LONG GROVE DR STE 1
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7579
Practice Address - Country:US
Practice Address - Phone:843-654-4013
Practice Address - Fax:843-654-5014
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist