Provider Demographics
NPI:1295092328
Name:O'SHEA, SUZANNE M (RN)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 PLANTATION HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-6239
Mailing Address - Country:US
Mailing Address - Phone:843-963-6994
Mailing Address - Fax:843-963-6543
Practice Address - Street 1:204 W. HILL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29404-0000
Practice Address - Country:US
Practice Address - Phone:843-963-6994
Practice Address - Fax:843-963-6543
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC77629163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care