Provider Demographics
NPI:1508223660
Name:SALYERS, SHANNON (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:
Last Name:SALYERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MEDICAL PARK DR.
Mailing Address - Street 2:SUITE 212 COLLETON CARDIOLOGY
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488
Mailing Address - Country:US
Mailing Address - Phone:843-782-4700
Mailing Address - Fax:
Practice Address - Street 1:302 MEDICAL PARK DR
Practice Address - Street 2:SUITE 212
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-5747
Practice Address - Country:US
Practice Address - Phone:843-782-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19929363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health