Healthcare Provider Details

I. General information

NPI: 1235780701
Provider Name (Legal Business Name): SHANA MAUREEN CAGNEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 SUGAR MAGNOLIA WAY
CHARLESTON SC
29414-9002
US

IV. Provider business mailing address

1031 ALBATROSS LN
MOUNT PLEASANT SC
29466-9163
US

V. Phone/Fax

Practice location:
  • Phone: 843-437-0376
  • Fax:
Mailing address:
  • Phone: 843-437-0376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: