Provider Demographics
NPI:1922336536
Name:BRUNSON, SARAH C (RN, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:BRUNSON
Suffix:
Gender:F
Credentials:RN, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9133 TIMBER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9075
Mailing Address - Country:US
Mailing Address - Phone:843-818-1123
Mailing Address - Fax:
Practice Address - Street 1:9133 TIMBER ST
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9075
Practice Address - Country:US
Practice Address - Phone:843-818-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC226359163W00000X, 163WL0100X
GARN241719163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant