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NPI Code Detail

MEDICARE: LORI ANNE BLACKBURN

MEDICARE: LORI ANNE BLACKBURN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1679169577
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANNE BLACKBURN
Provider Business Mailing Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-5007
Fax Number :
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-5007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2020
Last Update Date : 02/24/2026

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Directions to “ LORI ANNE BLACKBURN ” Practice Location

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