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General NPI Number Information
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NPI Number | 1003225525
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Entity Type | Individual
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Provider Name | HEIDI LEE BLAIR ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 425 N SANTIAM HWY
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City | LEBANON
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State | OR
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Zip | 97355-4361
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Country | US
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Telephone | 541-451-6960
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1193
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City | CORVALLIS
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State | OR
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Zip | 97339-1193
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A125704
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201506662NP-PP
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License Number State | OR
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