Womack, Alicia Dawn

Womack, Alicia Dawn is an individual health care provider with primary practice located at 139 Medical Center Dr , Gaffney SC 29340-4823. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Womack, Alicia Dawn can be contacted via phone (864) 487-7186.

Contact Information

Primary practice address
139 Medical Center Dr Gaffney SC 29340-4823
Fax: (864) 487-7246
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 19572 South Carolina

Profile Details

NPI number 1538541792
LBN Legal business name Womack, Alicia Dawn
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2015
Last updated Jan 9th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538541792 NPPES
South Carolina Other SC62595096 MEDICARE PIN
South Carolina Other SC62596121 MEDICARE PIN
South Carolina Other SC6259J577 MEDICARE PIN
South Carolina Other SC62596067 MEDICARE PIN
South Carolina MEDICAID NP3288 MEDICARE PIN

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