| Doctor Name: | JEANNINE PATRICK-BLAIKIE |
| NPI Number: | 1083739502 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | VP006532C |
| Business Practice Address: | 292 Frantz Rd Ste 108 Stroudsburg, PA - 183607455 |
| Business Phone Number: | 5704262960 |
| Business Fax Number: | 5704262965 |
| Mailing Address: | 206 E Brown St, EAST STROUDSBURG |
| State: | PA |
| Postal Code: | 183013006 |
| Phone Number: | 5704204951 |
| Fax Number: | 5704763754 |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 11/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | VP006532C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |