MEDICARE: MEGAN SUZANNE O'CONNELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	265393	SC

General Provider Information

NPI Number	:	1215774633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN SUZANNE O'CONNELL

Provider Business Mailing Address
First Line	:	3201 DUNWICK DR
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-8439
Country	:	US
Telephone Number	:	732-580-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	268 CALHOUN ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8906
Country	:	US
Telephone Number	:	843-792-5252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	07/12/2024

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