Individual
MARY E RADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1699 GARDEN ST, STONO PARK ELEMENTARY SCHOOL, CHARLESTON, SC 29407
(843) 852-4596
Mailing address
5754 SAINT ANGELA DR, NORTH CHARLESTON, SC 29418-5212
(843) 693-3030
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
91871
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91871
SC STATE BOARD OF NURSING
SC
Enumeration date
05/06/2013
Last updated
05/06/2013
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