MEDICARE: MARY ELIZABETH SHEARER DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	21139	SC

General Provider Information

NPI Number	:	1336664564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH SHEARER DNP

Provider Business Mailing Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8908
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-0001
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2017
Last Update Date	:	01/28/2026

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