Yolanda Bleasdale

Individual provider Active NPI Home Health Registered Nurse · Manning, SC

NPI 1295154235 · NPPES record last updated Apr 7, 2014

Key facts

NPI
1295154235
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
33951 (SC)
Practice address
110 Boyce Street
Manning, SC 29102
Phone
(803) 435-4355
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
33951SCMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 33951 SC Yes

Addresses

Primary practice location

110 Boyce Street
Manning, SC 29102

Mailing address

1938 Bloomville Rd
Manning, SC 29102-5905
Phone (803) 473-8072

Other providers in Manning, SC

All providers in Manning, SC · Home Health Registered Nurse in South Carolina

Sources for this page

Verify at the official NPI Registry.