Healthcare Provider Details

I. General information

NPI: 1750180907
Provider Name (Legal Business Name): ASHLEY H WHEELER AG ACNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5217 PLEASANT POINTE DR
WARRENVILLE SC
29851-3260
US

IV. Provider business mailing address

5217 PLEASANT POINTE DR
WARRENVILLE SC
29851-3260
US

V. Phone/Fax

Practice location:
  • Phone: 803-991-2802
  • Fax:
Mailing address:
  • Phone: 803-991-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number30023
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: