MRS. SHANNAN K. DUFAULT (NPI# 1275641144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275641144 |
| Entity Type | Individual |
| Full Name | MRS. SHANNAN K. DUFAULT |
| Other Name | MS. SHANNON K. TOOLE |
| Credential | NPN |
| Practice Address |
1952 Long Grove Dr Ste 202 Mount Pleasant SC 29464-7579 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8439712992 |
| Practice Fax Number | 8439712998 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
2139 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP0832 | 05 |
| Street Address |
1952 LONG GROVE DR STE 202 |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29464-7579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740443464 | Ana Isabel Arias-pandey | Pediatrics | 1952 Long Grove Dr Ste 202, Mount Pleasant, SC 29464-7579 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417442617 | Shelby Fredricks | Nurse Practitioner | 1205 S Mission St Ste 4, Mount Pleasant, MI 48858-3939 | 2018-06-29 |
| 1811916869 | Donna Thompson Broach | Nurse Practitioner | 1903 Mulberry Ave, Mount Pleasant, TX 75455-2369 | 2006-07-19 |
| 1336701317 | Gregory N Smith Jr. | Nurse Practitioner | 2001 N Jefferson Ave Ste 300, Mount Pleasant, TX 75455-2375 | 2019-07-01 |
| 1861884835 | Lena Brittany Martin Ingraham | Nurse Practitioner | 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2338 | 2015-02-26 |
| 1962748996 | Alice Gail Loguidice | Nurse Practitioner | 309 Wingo Way, Mount Pleasant, SC 29464-1804 | 2012-12-19 |
| 1043479181 | Linda Marie Mcdermott-gonzalez | Nurse Practitioner | 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2386 | 2008-06-04 |
| 1821085721 | Pediatric Clinic, P.a. | Nurse Practitioner | 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2371 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515511 | Naajah Hughes | Nurse Practitioner | 96 Jonathan Lucas Street Csb 428 Msc 608, Charleston, SC 29425-0001 | 2020-07-20 |
| 1558835355 | Conway Hospital Inc | Nurse Practitioner | 124 Professional Park Drive, Ste A, Conway, SC 29526-9260 | 2019-01-15 |
| 1104220433 | Diana L Taylor | Nurse Practitioner | 140 Professional Park Drive, Conway, SC 29526 | 2014-10-15 |
| 1134540008 | Jeanne Egli | Nurse Practitioner | 99 Bridgetown Rd, Goose Creek, SC 29445-5359 | 2013-12-19 |
| 1962839696 | Tracey Christine Wood | Nurse Practitioner | 140 Bandage Ct, Murrells Inlet, SC 29576-5103 | 2013-09-26 |
| 1982037495 | Amanda Mcallister | Nurse Practitioner | 1341 College Park Rd Ste A, Summerville, SC 29486 | 2013-08-20 |
| 1144568650 | Rebecca Pursley Brown | Nurse Practitioner | 128 Camelot Dr, Gaffney, SC 29341-1012 | 2013-01-18 |
| 1891097580 | Jocelyn Miller Snider | Nurse Practitioner | 1223 S Lake Dr, Lexington, SC 29073-6889 | 2010-12-01 |
| 1972805190 | Care House of The Pee Dee Inc | Nurse Practitioner | 1500 Patton Dr, Florence, SC 29501-6520 | 2010-11-19 |
| 1841436219 | Elsie May Hartigan | Nurse Practitioner | 834 W. Meeting St. Suite C, Lancaster, SC 29720 | 2009-01-06 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29464 |
Please comment or provide details below to improve the information on MRS. SHANNAN K. DUFAULT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.