Blake, Anne B
Blake, Anne B is an individual health care provider with primary practice located at 710 Dewitt Dr , Lugoff SC 29078-9069. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blake, Anne B can be contacted via phone (803) 438-7566.Contact Information
Primary practice address
710 Dewitt Dr
Lugoff SC 29078-9069
Phone: (803) 438-7566
Fax: (803) 438-4371
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 1450 | South Carolina |
Profile Details
| NPI number | 1225089857 |
|---|---|
| LBN Legal business name | Blake, Anne B |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Feb 24th, 2012 - about 14 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 | 1225089857 | NPPES |
| South Carolina | Other | 500022911 | RAILROAD MEDICARE PIN |
| South Carolina | Other | B5703 | RAILROAD MEDICARE PIN |
| South Carolina | MEDICAID | NP0429 | RAILROAD MEDICARE PIN |
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