Bonnie Lee Blue, C.N.A
Individual provider Active NPI Contractor · Florence, SC
NPI 1477563278 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1477563278
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 062729 (SC)
- Practice address
- 4023 E National Cemetery Rd
Florence, SC 29506-5238 - Phone
- (843) 229-2201
- NPI assigned
- Aug 8, 2006
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 062729 | SC | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 062729 | SC | Yes |
Addresses
Primary practice location
4023 E National Cemetery Rd
Florence, SC 29506-5238
Mailing address
4023 E National Cemetery Rd
Florence, SC 29506-5238
Phone (843) 229-2201
Other providers in Florence, SC
- Dorothy Lynn Bloodworth
- Bloom Haven Therapy LLC
- Blooming in Adversity LLC
- Blossom & Bloom Women'S Health and Wellness, LLC
- Sheila Michelle Blossom
- Gail Veronica Blue
- Brittany Boatwright
- Lindsay Scruggs Boatwright
- James Floyd Bobo
- Iris A Boctor
All providers in Florence, SC · Contractor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.