Individual
MICHELLE RAE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
8161 WARREN H ABERNATHY HWY, SPARTANBURG, SC 29301-2451
(864) 586-1152
Mailing address
PO BOX 639917, CINCINNATI, OH 45263-9917
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024177529
VA
363LF0000X
Family Nurse Practitioner
Primary
24897
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7525
—
SC
01
—
SCK1055019
MEDICARE PIN
SC
01
—
SCK1056067
MEDICARE PIN
SC
01
—
SCK1056084
MEDICARE PIN
SC
01
—
SCK105J577
MEDICARE PIN
SC
Enumeration date
04/16/2019
Last updated
01/03/2024
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