Individual
TAKASHA BLASSINGAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 CAMDEN DR, PIEDMONT, SC 29673-9227
(864) 361-2990
Mailing address
118 CAMDEN DR, PIEDMONT, SC 29673-9227
(864) 361-2990
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
238943
SC
163WC1600X
Continuing Education/Staff Development Registered Nurse
238943
SC
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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