Doctor Name: | JESSICA K BLAND |
NPI Number: | 1164556130 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD MSPT |
License Number: | 0600003406 |
Business Practice Address: | 759 Chestnut St Springfield, MA - 011991001 |
Business Phone Number: | 4137967494 |
Business Fax Number: | |
Mailing Address: | 690 Canton St, Suite 325 WESTWOOD |
State: | MA |
Postal Code: | 020902321 |
Phone Number: | 7814077713 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 08/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 0600003406 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VT |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |