Black, Neicole Dutton

Black, Neicole Dutton is an individual health care provider with primary practice located at 2410 Hoffmeyer Rd , Florence SC 29501-7311. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Black, Neicole Dutton can be contacted via phone (843) 882-6162.

Contact Information

Primary practice address
2410 Hoffmeyer Rd Florence SC 29501-7311
Phone: (843) 882-6162
Fax: (843) 662-8183
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1091 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1091 South Carolina

Profile Details

NPI number 1033158548
LBN Legal business name Black, Neicole Dutton
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Sep 5th, 2019 - about 5 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 1033158548 NPPES
North Carolina MEDICAID 8103286
North Carolina Other 1091

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