Fishback, Angela Louise

Fishback, Angela Louise is an individual health care provider with primary practice located at 2720 Sunset Blvd , West Columbia SC 29169-4810. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Fishback, Angela Louise can be contacted via phone (803) 791-2000.

Contact Information

Primary practice address
2720 Sunset Blvd West Columbia SC 29169-4810
Phone: (803) 791-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2277 South Carolina

Profile Details

NPI number 1891751517
LBN Legal business name Fishback, Angela Louise
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Oct 8th, 2009 - about 16 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 1891751517 NPPES
South Carolina MEDICAID AN0094

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