Individual
SHANNON ILENE COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
TAYLOR AT MARRION ST, COLUMBIA, SC 29220-0001
(803) 296-2276
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
83980
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
3281
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1926
—
SC
Enumeration date
01/29/2007
Last updated
02/25/2022
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