Healthcare Provider Details

I. General information

NPI: 1033034954
Provider Name (Legal Business Name): ANNA CLAR WILKS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3999 BRIDGE VIEW DR
NORTH CHARLESTON SC
29405-7472
US

IV. Provider business mailing address

3999 BRIDGE VIEW DR
NORTH CHARLESTON SC
29405-7472
US

V. Phone/Fax

Practice location:
  • Phone: 843-745-2184
  • Fax: 843-745-2183
Mailing address:
  • Phone: 843-745-2184
  • Fax: 843-745-2183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number88673
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: