Healthcare Provider Details

I. General information

NPI: 1316197353
Provider Name (Legal Business Name): MYRA D PINCKNEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 SWAMP CREEK LN
MONCKS CORNER SC
29461-7474
US

IV. Provider business mailing address

243 SWAMP CREEK LN
MONCKS CORNER SC
29461-7474
US

V. Phone/Fax

Practice location:
  • Phone: 843-534-8468
  • Fax: 866-829-1906
Mailing address:
  • Phone: 843-534-8468
  • Fax: 866-829-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5364
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number20707
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: