Healthcare Provider Details

I. General information

NPI: 1760394456
Provider Name (Legal Business Name): ABIGAIL BLINN BS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 WILSON RD
ASHLAND OR
97520-9323
US

IV. Provider business mailing address

968 WILSON RD
ASHLAND OR
97520-9323
US

V. Phone/Fax

Practice location:
  • Phone: 717-398-5907
  • Fax:
Mailing address:
  • Phone: 717-398-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD-D-10273296
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: