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General NPI Number Information
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NPI Number | 1366433294
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Entity Type | Individual
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Provider Name | SUSAN ELLEN MYERS WHNPC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3 CHARLESTON CENTER DR CHARLESTON COUNTY HEALTH CLINIC
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City | CHARLESTON
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State | SC
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Zip | 29401-1162
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Country | US
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Telephone | 843-579-4606
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Fax | 843-570-4621
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Provider Business Mailing Address
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Address Line | 1453 DIAMOND BLVD
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City | MT PLEASANT
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State | SC
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Zip | 29466-9464
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Country | US
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Telephone | 843-849-8523
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APN 620
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License Number State | SC
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