Provider Demographics
NPI:1316091192
Name:SHIVER, JULIE T (RN)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:T
Last Name:SHIVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:T
Other - Last Name:GIDDENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:309 CEDAR FIELD LN
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-1232
Mailing Address - Country:US
Mailing Address - Phone:803-546-5295
Mailing Address - Fax:
Practice Address - Street 1:10 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:EMERGENCY SERVICES
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6892
Practice Address - Country:US
Practice Address - Phone:803-898-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR79798163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult