Individual
BRANDI BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1102 ROBERTS ST, CAMDEN, SC 29020-3734
(803) 432-7682
Mailing address
PO BOX 23321, NEW YORK, NY 10087-4321
(803) 432-7682
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
SC
Other
Enumeration date
02/09/2026
Last updated
02/11/2026
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