Provider Demographics
NPI:1922894484
Name:WILSON, SHIKINA SYMONE
Entity type:Individual
Prefix:
First Name:SHIKINA
Middle Name:SYMONE
Last Name:WILSON
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 1:100 PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-3263
Mailing Address - Country:US
Mailing Address - Phone:803-607-0223
Mailing Address - Fax:
Practice Address - Street 1:100 PALMETTO ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-3263
Practice Address - Country:US
Practice Address - Phone:803-607-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10095294374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide