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NPI Code Detail

MEDICARE: MRS. CAROLYN C WYSONG R.N

MEDICARE: MRS. CAROLYN C WYSONG R.N
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
1163WS0200XSchool Registered Nurse70462SC

General Provider Information

NPI Number : 1528491578
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN C WYSONG R.N
Provider Business Mailing Address
First Line : 3180 THOMASINA MCPHERSON BLVD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-8283
Country : US
Telephone Number : 843-745-7131
Fax Number : 843-529-3927
Provider Business Practice Location Address
First Line : 3180 THOMASINA MCPHERSON BLVD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-8283
Country : US
Telephone Number : 843-745-7131
Fax Number : 843-529-3927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2013
Last Update Date : 08/13/2013

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