Healthcare Provider Details

I. General information

NPI: 1164514345
Provider Name (Legal Business Name): SHELLEY LOVELL COKER NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

IV. Provider business mailing address

901 E CHEVES ST SUITE 370
FLORENCE SC
29506-2716
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-8380
  • Fax:
Mailing address:
  • Phone: 843-667-6229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1670
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: