Blaine, Charlene Lydia
Blaine, Charlene Lydia is an individual health care provider with primary practice located at 343 Technology Dr Suite 1110, Garner NC 27529-7949. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pulmonary Diagnostics, which is considered as her primary health care specialty. Blaine, Charlene Lydia can be contacted via phone (919) 780-5900.Contact Information
Primary practice address
343 Technology Dr Suite 1110
Garner NC 27529-7949
Phone: (919) 780-5900
Fax: (919) 780-5905
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pulmonary Diagnostics | 2278P1004X | A-4125 | North Carolina |
Profile Details
| NPI number | 1720050578 |
|---|---|
| LBN Legal business name | Blaine, Charlene Lydia |
| Credentials | CRT, RCP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | May 10th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720050578 | NPPES |
| North Carolina | Other | 139EE | BLUE SHIELD NC |
| North Carolina | MEDICAID | 7492701 | BLUE SHIELD NC |
| North Carolina | Other | A-4125 | BLUE SHIELD NC |
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