Blake, Christina L

Blake, Christina L is an individual health care provider with primary practice located at 106 W Georgia Rd , Simpsonville SC 29681-2302. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Blake, Christina L can be contacted via phone (864) 662-6840.

Contact Information

Primary practice address
106 W Georgia Rd Simpsonville SC 29681-2302
Phone: (864) 662-6840
Fax: (864) 448-1720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 225614 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 211071 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 21071 South Carolina

Profile Details

NPI number 1245765841
LBN Legal business name Blake, Christina L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2017
Last updated Mar 19th, 2024 - about last year

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 1245765841 NPPES
South Carolina MEDICAID NP4579
South Carolina Other SCA8307652

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