Provider Demographics
NPI:1881934263
Name:SHEALY, ERIN MAYS (APRN, FNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MAYS
Last Name:SHEALY
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WALDEN HEIGHTS DR
Mailing Address - Street 2:APT 438
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7865
Mailing Address - Country:US
Mailing Address - Phone:803-924-8659
Mailing Address - Fax:
Practice Address - Street 1:1008 LAKE MURRAY BLVD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2821
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily