Doctor Name: | ELISA M BLAIR |
NPI Number: | 1134496300 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, BSN |
License Number: | 180531 |
Business Practice Address: | 308 N Mesa St Fruita, CO - 815212108 |
Business Phone Number: | 9702103767 |
Business Fax Number: | |
Mailing Address: | 308 N Mesa St, FRUITA |
State: | CO |
Postal Code: | 815212108 |
Phone Number: | 9702103767 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2011 |
NPI Last Update Date: | 11/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0400X |
License Number: | 180531 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Case Management |
Taxonomy Definition: |