Brazell, Peggy Loree

Brazell, Peggy Loree is an individual health care provider with primary practice located at 255 Enterprise Blvd Suite 101, Greenville SC 29615-6300. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Brazell, Peggy Loree can be contacted via phone (864) 454-8120.

Contact Information

Primary practice address
255 Enterprise Blvd Suite 101 Greenville SC 29615-6300
Phone: (864) 454-8120
Fax: (864) 454-8125
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 3023 South Carolina

Profile Details

NPI number 1841247244
LBN Legal business name Brazell, Peggy Loree
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Jan 26th, 2018 - 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 1841247244 NPPES
South Carolina MEDICAID NP1046

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