Mikelle Gaston, APRN
Individual provider Active NPI Family Nurse Practitioner · Cayce, SC
NPI 1679215628 · NPPES record last updated Apr 11, 2022
Key facts
- NPI
- 1679215628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 23888 (SC)
- Practice address
- 114 Sandy LN
Cayce, SC 29033-2718 - Phone
- (803) 237-6143
- NPI assigned
- Apr 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23888 | SC | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23888 | SC | Yes |
Addresses
Primary practice location
114 Sandy LN
Cayce, SC 29033-2718
Mailing address
114 Sandy LN
Cayce, SC 29033-2718
Phone (803) 237-6143
Other providers in Cayce, SC
- Keya Williams Fowler
- Jeffrey Andrew Gage
- Jonathan Gardner
- Phillip Reid Gardner
- Frederick Michael Gass
- Tiffany Gethers
- Chasity Darcell Gilliam
- Jean Ann Whyte Goette
- Ellis Austin Goodwin
- Wendy K Graham
All providers in Cayce, SC · Family Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.