Provider Demographics
NPI:1538748017
Name:WESTBROOK, SEMICA
Entity type:Individual
Prefix:
First Name:SEMICA
Middle Name:
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SEMICA
Other - Middle Name:
Other - Last Name:WESTBROOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHLEBOTOMIST
Mailing Address - Street 1:PO BOX 80684
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30608-0684
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 CHADDS WALK
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-1472
Practice Address - Country:US
Practice Address - Phone:706-427-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-03
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy