| Dr Aleisa Baksh, DNP, FNP-C | |
| 
					1612 Jones Bridge Rd, Blackville, SC 29817-3066  | |
| (803) 284-4313 | |
| Not Available | 
| Full Name | Dr Aleisa Baksh | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 1612 Jones Bridge Rd, Blackville, South Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316779325 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 29221 (South Carolina) | Primary | 
| Entity Name | Ch Specialty Services Sc Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1275915522 PECOS PAC ID: 6608182993 Enrollment ID: O20150901002450  | 
| Entity Name | Elite Patient Care Of South Carolina Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1316477896 PECOS PAC ID: 1951672617 Enrollment ID: O20170731000866  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Aleisa Baksh, DNP, FNP-C 529 Raleigh Dr, Graniteville, SC 29829-4123 Ph: (803) 295-6179  | Dr Aleisa Baksh, DNP, FNP-C 1612 Jones Bridge Rd, Blackville, SC 29817-3066 Ph: (803) 284-4313  | 
Ms. Kimberly Spires, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 130 Baker Street, Blackville, SC 29817 Phone: 803-284-1045 Fax: 803-284-3094  | |
Mrs. Amy Ellis Kinard, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 130 Baker St N, Blackville, SC 29817 Phone: 803-284-1045 Fax: 803-284-3094  |