| Doctor Name: | ANGELA LYNN BLAIR |
| NPI Number: | 1033511225 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | RN186218 |
| Business Practice Address: | 703 E 9th St North Bdlg 4970 Rm 319 Fort Stewart, GA - 31314 |
| Business Phone Number: | 9124351327 |
| Business Fax Number: | 9124356151 |
| Mailing Address: | 703 E 9th St North, Bdlg 4970 Rm 319 FORT STEWART |
| State: | GA |
| Postal Code: | 31314 |
| Phone Number: | 9124351327 |
| Fax Number: | 9124356151 |
| NPI Enumeration Date: | 09/19/2014 |
| NPI Last Update Date: | 09/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | RN186218 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |