Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Katie Gardner Nickerson, PA-C

Individual provider Physician Assistant · NPI 1720358070

Katie Gardner Nickerson, PA-C is a Physician Assistant in North Charleston, South Carolina. Licensed in North Carolina and South Carolina. Registered with an NPI since 2012.

Licensed in
NC, SC
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

8740 Rivers Ave
North Charleston, SC 29406-9211
Phone: (843) 572-5990
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2251 (SC)
Physician Assistant Taxonomy 363A00000X · Licence 0010-03197 (NC)

Record details

NPI number1720358070
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 4, 2012
Last updated in NPPESMarch 9, 2017

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