Individual
LEIGH ANN BLENDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3555 HARDEN STREET EXT STE 141, COLUMBIA, SC 29203-6894
(803) 434-4300
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 434-4300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
219948
SC
363L00000X
Nurse Practitioner
23247
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
23247
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6273
—
SC
01
—
SCG209A634
MEDICARE PART B
SC
Enumeration date
06/10/2016
Last updated
05/03/2021
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