Provider Demographics
NPI:1316375942
Name:SHEARON-HANNA, LORIE JANE (RN,CDE)
Entity Type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:JANE
Last Name:SHEARON-HANNA
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:MS
Other - First Name:LORIE
Other - Middle Name:JANE
Other - Last Name:SHEARON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CDE
Mailing Address - Street 1:2000 HOSPITAL DR
Mailing Address - Street 2:SUITE 5110
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3764
Mailing Address - Country:US
Mailing Address - Phone:843-416-6595
Mailing Address - Fax:843-416-6937
Practice Address - Street 1:2000 HOSPITAL DR
Practice Address - Street 2:SUITE 5110
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3764
Practice Address - Country:US
Practice Address - Phone:843-416-6595
Practice Address - Fax:843-416-6937
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20710373133NN1002X
SC20710373163WD0400X
SC71670174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20710373OtherDIABETES EDUCATION MANAGEMENT