Provider Demographics
NPI:1386078681
Name:FARRELL, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PONSBURY RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6601
Mailing Address - Country:US
Mailing Address - Phone:843-216-2883
Mailing Address - Fax:843-216-8880
Practice Address - Street 1:250 PONSBURY RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6601
Practice Address - Country:US
Practice Address - Phone:843-216-2883
Practice Address - Fax:843-216-8880
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC79139163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool