Blake, Sally S
Blake, Sally S is an individual health care provider with primary practice located at 2319 Saint Matthews Rd , Orangeburg SC 29118. 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, Sally S can be contacted via phone (803) 536-1571.Contact Information
Primary practice address
2319 Saint Matthews Rd
Orangeburg SC 29118
Phone: (803) 536-1571
Fax: (803) 534-3860
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 710 | South Carolina |
Profile Details
| NPI number | 1750432985 |
|---|---|
| LBN Legal business name | Blake, Sally S |
| Credentials | FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Feb 11th, 2019 - about 6 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 | 1750432985 | NPPES |
| South Carolina | Other | 710 | STATE LICENSE # |
| South Carolina | MEDICAID | NP1060 | STATE LICENSE # |
| South Carolina | Other | F710 | STATE LICENSE # |
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