MEDICARE: TAMBERLYN KATHLEEN BLINSINK N.D.

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
1	175F00000X	Naturopath	NT00001125	WA

General Provider Information

NPI Number	:	1700112539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMBERLYN KATHLEEN BLINSINK N.D.

Provider Business Mailing Address
First Line	:	321 NORMANDY RD
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-8432
Country	:	US
Telephone Number	:	704-796-0827
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 W A ST
Second Line	:
City	:	KANNAPOLIS
State	:	NC
Zip	:	28081-3206
Country	:	US
Telephone Number	:	704-796-0827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2009
Last Update Date	:	10/29/2009

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