Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Justin Nicole Kernodle, PA-C

Individual provider Medical Physician Assistant · NPI 1477995470

Mrs. Justin Nicole Kernodle, PA-C is a Medical Physician Assistant in Charleston, South Carolina. Licensed in South Carolina. Registered with an NPI since 2013.

Licensed in
SC
In the registry since
2013
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

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone: (843) 402-1037
Fax: (843) 402-1295
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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 1941 (SC)
Medical Physician Assistant Taxonomy 363AM0700X · Licence TL1941 (SC)

Record details

NPI number1477995470
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 19, 2013
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

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