Provider Demographics
NPI:1154297273
Name:SMALLS, NYKEIA
Entity type:Individual
Prefix:
First Name:NYKEIA
Middle Name:
Last Name:SMALLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3728 LOWCOUNTRY HWY
Mailing Address - Street 2:
Mailing Address - City:YEMASSEE
Mailing Address - State:SC
Mailing Address - Zip Code:29945-4112
Mailing Address - Country:US
Mailing Address - Phone:843-599-3523
Mailing Address - Fax:843-844-8691
Practice Address - Street 1:3728 LOWCOUNTRY HWY
Practice Address - Street 2:
Practice Address - City:YEMASSEE
Practice Address - State:SC
Practice Address - Zip Code:29945-4112
Practice Address - Country:US
Practice Address - Phone:843-599-3523
Practice Address - Fax:843-844-8691
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC616CNW347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle