Fuentes, Brooke Webster

Fuentes, Brooke Webster is an sole proprietor health care provider with primary practice located at 300 E Blackstock Road Suite E, Spartanburg SC 29301. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Fuentes, Brooke Webster can be contacted via phone (864) 285-9861.

Contact Information

Primary practice address
300 E Blackstock Road Suite E Spartanburg SC 29301
Phone: (864) 285-9861
Fax: (864) 595-8281
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0110003582 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1790 South Carolina

Profile Details

NPI number 1649564063
LBN Legal business name Fuentes, Brooke Webster
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 2nd, 2011
Last updated Jan 13th, 2016 - about 10 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 1649564063 NPPES
South Carolina MEDICAID 1484PA

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