Individual
ANN SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2910 TRICOM ST STE 100, NORTH CHARLESTON, SC 29406-9351
(843) 572-9211
(843) 572-0457
Mailing address
PO BOX 751874, CHARLOTTE, NC 28275-1874
(843) 402-5200
(843) 402-5296
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
24125
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6971
—
SC
Enumeration date
07/30/2020
Last updated
09/30/2025
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