Individual
SUSANNA HEFFERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4060 WILDCAT BLVD, CHARLESTON, SC 29414-5851
(843) 573-1201
(843) 573-1223
Mailing address
4060 WILDCAT BLVD, CHARLESTON, SC 29414-5851
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
102850
SC
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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