Blakely, Deborah Denise

Blakely, Deborah Denise is an individual health care provider with primary practice located at 171 Ashley Ave , Charleston SC 29425-8908. 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. Blakely, Deborah Denise can be contacted via phone (843) 792-1414.

Contact Information

Primary practice address
171 Ashley Ave Charleston SC 29425-8908
Phone: (843) 792-1414
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA10004719 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2064 South Carolina

Profile Details

NPI number 1346294139
LBN Legal business name Blakely, Deborah Denise
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Dec 5th, 2017 - about 7 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 1346294139 NPPES
Washington MEDICAID 8410078

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