Provider Demographics
NPI:1336300748
Name:O'NEAL, SARANNE S (FNPC)
Entity Type:Individual
Prefix:MS
First Name:SARANNE
Middle Name:S
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 WREN ST
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-1529
Mailing Address - Country:US
Mailing Address - Phone:803-259-5762
Mailing Address - Fax:803-259-3250
Practice Address - Street 1:10706 MARLBORO AVE
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-6376
Practice Address - Country:US
Practice Address - Phone:803-259-7337
Practice Address - Fax:803-259-3250
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1234363LF0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCFNP003Medicaid
SC1234OtherMEDICAL LICENSE
SC105031Medicaid
SCD90835Medicare UPIN
SCRHC004Medicaid
SC570858468OtherCOMMERCIAL