| Jacqueline Gabrielle Wiles, APRN, FNP-BC | |
| 
					200 Booker Dr, Walhalla, SC 29691-2278  | |
| (864) 656-3076 | |
| (843) 985-9562 | 
| Full Name | Jacqueline Gabrielle Wiles | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 200 Booker Dr, Walhalla, South Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1588211197 | NPI | - | NPPES | 
| NP6253 | Medicaid | SC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 23172 (South Carolina) | Primary | 
| Entity Name | Clemson University | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1093990707 PECOS PAC ID: 1850393786 Enrollment ID: O20121206000375  | 
| Entity Name | Prisma Health Urgent Care Of South Carolina Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1851000855 PECOS PAC ID: 1254703788 Enrollment ID: O20230210000249  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jacqueline Gabrielle Wiles, APRN, FNP-BC 200 Booker Dr, Walhalla, SC 29691-2278 Ph: (864) 656-3076  | Jacqueline Gabrielle Wiles, APRN, FNP-BC 200 Booker Dr, Walhalla, SC 29691-2278 Ph: (864) 656-3076  | 
Ms. Christina Diane Smith, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Booker Dr, Walhalla, SC 29691 Phone: 864-656-3076  | |
Michelle Marie Deem, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Booker Dr, Walhalla, SC 29691 Phone: 864-656-3076 Fax: 843-985-9562  | |
Margot Veronique Rabren, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 103 Whitetail Dr, Walhalla, SC 29691 Phone: 864-638-3444 Fax: 864-638-3445  | |
Keri Marlene Dickson, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 Whitetail Dr, Walhalla, SC 29691 Phone: 864-638-3444 Fax: 864-638-3445  |