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1275641144
SHANNAN K. DUFAULT
MOUNT PLEASANT, SC
NPI
1275641144
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Former Name
SHANNON K. TOOLE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: SC 2139)
Enumeration Date
2006-08-29
Last Update Date
2019-11-18
Business Address
Mrs. SHANNAN K. DUFAULT NPN
1952 LONG GROVE DR STE 202
MOUNT PLEASANT, SC 29464-7579
Phone number: 843-971-2992
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Mailing Address
Mrs. SHANNAN K. DUFAULT NPN
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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