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General NPI Number Information
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NPI Number | 1265770770
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Entity Type | Individual
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Provider Name | SHARON M HASELDEN RN
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Gender | Female
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Dates
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Enumeration Date | 01/18/2013
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 237 S GEORGETOWN HWY
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City | JOHNSONVILLE
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State | SC
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Zip | 29555-8081
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Country | US
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Telephone | 843-386-2609
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Fax | 843-386-3125
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Provider Business Mailing Address
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Address Line | PO BOX 861 652 S. MIDWAY HWY
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City | JOHNSONVILLE
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State | SC
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Zip | 29555-0861
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Country | US
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Telephone | 843-386-2609
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Fax | 843-386-3125
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 39534
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License Number State | SC
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