Lively, Michele

Lively, Michele is an individual health care provider with primary practice located at 1301 Creel St , Conway SC 29527-5018. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Lively, Michele can be contacted via phone (843) 248-4414.

Contact Information

Primary practice address
1301 Creel St Conway SC 29527-5018
Phone: (843) 248-4414
Fax: (843) 248-3781
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1075 South Carolina

Profile Details

NPI number 1437116241
LBN Legal business name Lively, Michele
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Apr 10th, 2020 - 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 1437116241 NPPES
South Carolina MEDICAID NP0471

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