Provider Demographics
NPI:1225141021
Name:SHULER, THELMA LAURETTA (APRNBC WHNP)
Entity Type:Individual
Prefix:
First Name:THELMA
Middle Name:LAURETTA
Last Name:SHULER
Suffix:
Gender:F
Credentials:APRNBC WHNP
Other - Prefix:
Other - First Name:THELMA
Other - Middle Name:LAURETTA
Other - Last Name:PENDARVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRNBC WHNP
Mailing Address - Street 1:1469 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:COPE
Mailing Address - State:SC
Mailing Address - Zip Code:29038-9103
Mailing Address - Country:US
Mailing Address - Phone:803-531-5141
Mailing Address - Fax:
Practice Address - Street 1:1550 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-1550
Practice Address - Country:US
Practice Address - Phone:803-533-7121
Practice Address - Fax:803-268-7373
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC834363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health