Arica Skylar Gandy

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Latta, SC

NPI 1376438465 · NPPES record last updated Jun 10, 2025

Key facts

NPI
1376438465
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
257 Hattie LN
Latta, SC 29565-4160
Phone
(843) 845-2316
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

257 Hattie LN
Latta, SC 29565-4160

Mailing address

257 Hattie LN
Latta, SC 29565-4160
Phone (843) 845-2316

Other providers in Latta, SC

All providers in Latta, SC · Student in an Organized Health Care Education/Training Program in South Carolina

Sources for this page

Verify at the official NPI Registry.