Healthcare Provider Details

I. General information

NPI: 1952448706
Provider Name (Legal Business Name): KIM SHAPIRO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 NASSAU ST
CHARLESTON SC
29403-5513
US

IV. Provider business mailing address

PO BOX 22581
NEW YORK NY
10087-2581
US

V. Phone/Fax

Practice location:
  • Phone: 843-722-4112
  • Fax:
Mailing address:
  • Phone: 610-482-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number27868
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: