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General NPI Number Information
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NPI Number | 1689140451
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Entity Type | Individual
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Provider Name | NICHOLE LEMAY PA
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Gender | Female
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 2728 SUNSET BLVD STE 400
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4872
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Country | US
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Telephone | 803-744-4900
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Fax | 803-744-4938
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Provider Business Mailing Address
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Address Line | PO BOX 6069
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City | WEST COLUMBIA
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State | SC
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Zip | 29171-6069
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Country | US
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Telephone | 803-744-4900
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Fax | 803-744-4938
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3269
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License Number State | SC
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