Moore, Norman Blake

Moore, Norman Blake is an sole proprietor health care provider with primary practice located at 2720 Sunset Blvd , West Columbia SC 29169-4810. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Moore, Norman Blake can be contacted via phone (803) 935-8538.

Contact Information

Primary practice address
2720 Sunset Blvd West Columbia SC 29169-4810
Phone: (803) 935-8538
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1-090700 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 901401 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 26371 South Carolina

Profile Details

NPI number 1225030372
LBN Legal business name Moore, Norman Blake
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Jun 19th, 2024 - about 5 months 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 1225030372 NPPES
Mississippi MEDICAID 01934777

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