Individual
MRS. SHANNAN KARLAYNE TOOLE DUFAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPN
Contact information
Practice address
2016 1ST AVE, SUMMERVILLE, SC 29486-0408
(843) 873-4545
(843) 873-1561
Mailing address
1500 RIVERTOWNE COUNTRY CLUB DR, MOUNT PLEASANT, SC 29466-8700
(843) 270-5902
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2139
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0832
—
SC
Enumeration date
08/29/2006
Last updated
02/03/2025
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