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General NPI Number Information
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NPI Number | 1295092328
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Entity Type | Individual
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Provider Name | SUZANNE M O'SHEA RN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 204 W. HILL BLVD
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City | CHARLESTON
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State | SC
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Zip | 29404-0000
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Country | US
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Telephone | 843-963-6994
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Fax | 843-963-6543
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Provider Business Mailing Address
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Address Line | 4008 PLANTATION HOUSE RD
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City | SUMMERVILLE
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State | SC
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Zip | 29485-6239
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Country | US
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Telephone | 843-963-6994
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Fax | 843-963-6543
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 77629
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License Number State | SC
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