Healthcare Provider Details

I. General information

NPI: 1376875674
Provider Name (Legal Business Name): SHARON SCHWARZ APRN-BC CNS DM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE ROOM 357Q RT
CHARLESTON SC
29425-8908
US

IV. Provider business mailing address

171 ASHLEY AVE ROOM 357Q RT
CHARLESTON SC
29425-8908
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-0462
  • Fax: 843-876-1253
Mailing address:
  • Phone: 843-876-0462
  • Fax: 843-876-1253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number1762
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: