Healthcare Provider Details

I. General information

NPI: 1174955660
Provider Name (Legal Business Name): SARAH FRENCH CONRAD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 CHARLIE HALL BLVD
CHARLESTON SC
29414-5834
US

IV. Provider business mailing address

2051 CHARLIE HALL BLVD
CHARLESTON SC
29414-5834
US

V. Phone/Fax

Practice location:
  • Phone: 843-573-2535
  • Fax: 843-573-2534
Mailing address:
  • Phone: 843-573-2535
  • Fax: 843-573-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN595226
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number26NR16383200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number18551
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: