Individual
LAUREN T SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
18385
SC
363LG0600X
Gerontology Nurse Practitioner
18385
SC
363LP2300X
Primary Care Nurse Practitioner
18385
SC
Other
Enumeration date
09/30/2013
Last updated
04/08/2015
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