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General NPI Number Information
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NPI Number | 1114548690
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Entity Type | Individual
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Provider Name | REBECCA BLAGUSKI CERTIFIED REGISTERED
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | THE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA 3400 SPRUCE STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-316-5151
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Fax |
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Provider Business Mailing Address
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Address Line | 1199 LUDLOW STREET APARTMENT 2406
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 905-531-0611
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN719286
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP021361
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP021361
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License Number State | PA
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