Individual
SUSAN STACKER SHEALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN MSN CPNP PC
Contact information
Practice address
1307 N LOGAN ST, GAFFNEY, SC 29341-2026
(864) 488-1333
Mailing address
2224 OLD FURNACE RD, BOILING SPRINGS, SC 29316-5782
(864) 578-8720
(864) 599-5675
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN.17546 RX
SC
Other
Enumeration date
07/15/2011
Last updated
07/15/2011
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