MEDICARE: JOAN CLAIRE WHEELER

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	163WS0200X	School Registered Nurse	218713	SC

General Provider Information

NPI Number	:	1952746992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN CLAIRE WHEELER

Provider Business Mailing Address
First Line	:	1999 SINGLEY ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-5014
Country	:	US
Telephone Number	:	843-745-2006
Fax Number	:	843-745-7191

Provider Business Practice Location Address
First Line	:	1999 SINGLEY ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-5014
Country	:	US
Telephone Number	:	843-745-2006
Fax Number	:	843-745-7191

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

Provider Enumeration Date	:	05/03/2013
Last Update Date	:	05/03/2013

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