Individual
CHASITY SHADOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
641 W WESMARK BLVD, SUMTER, SC 29150-1900
(803) 905-6944
Mailing address
641 W WESMARK BLVD, SUMTER, SC 29150-1900
(803) 905-6944
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20748
SC
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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