Provider Demographics
NPI:1194299115
Name:AVENOT, SHARON DAYSE (RN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:DAYSE
Last Name:AVENOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 N SMOKERISE WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7610
Mailing Address - Country:US
Mailing Address - Phone:843-817-3706
Mailing Address - Fax:
Practice Address - Street 1:1935 N SMOKERISE WAY
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7610
Practice Address - Country:US
Practice Address - Phone:843-817-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-12
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC239683163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000OtherNA
000000000OtherOTHER