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Individual
SARA T SHEALY
Active
Individual
SARA T SHEALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
80204
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80204
STATE LICENSE
SC
Enumeration date
10/30/2018
Last updated
10/30/2018
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