Provider Demographics
NPI:1871912188
Name:MCMAHANCARSONM, NANCY CARSON (RN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CARSON
Last Name:MCMAHANCARSONM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:CARSON
Other - Last Name:MCMAHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:736 SWANSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9140
Mailing Address - Country:US
Mailing Address - Phone:843-834-8205
Mailing Address - Fax:
Practice Address - Street 1:3 CHARLESTON CENTER DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1162
Practice Address - Country:US
Practice Address - Phone:843-834-8205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31878163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health