Healthcare Provider Details

I. General information

NPI: 1033104286
Provider Name (Legal Business Name): CATHY J SHEEHY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 PAMPLICO HWY
FLORENCE SC
29505-6047
US

IV. Provider business mailing address

420 WOODLAND DR
FLORENCE SC
29501-5445
US

V. Phone/Fax

Practice location:
  • Phone: 843-674-5000
  • Fax:
Mailing address:
  • Phone: 740-590-2417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number197797
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28440
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: