Healthcare Provider Details

I. General information

NPI: 1730747981
Provider Name (Legal Business Name): CLAIRE BLUMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 1ST ST
CENTRALIA KS
66415-9637
US

IV. Provider business mailing address

801 ALSTON ST
MARYSVILLE KS
66508-1542
US

V. Phone/Fax

Practice location:
  • Phone: 785-857-3334
  • Fax: 785-857-3397
Mailing address:
  • Phone: 785-447-9332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: