Healthcare Provider Details

I. General information

NPI: 1669726279
Provider Name (Legal Business Name): PATRICIA L BLAIR MSN, ACNS-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-2200
US

IV. Provider business mailing address

222 CHESTNUT WAY
MIDDLETOWN DE
19709-9348
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1700
  • Fax:
Mailing address:
  • Phone: 302-733-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberL9-0000118
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: