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General NPI Number Information
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NPI Number | 1295465417
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Entity Type | Individual
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Provider Name | JILL GLAZIER BLASDELL
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Gender | Female
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 329 S 350 E STE 4
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City | KANAB
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State | UT
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Zip | 84741-3768
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Country | US
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Telephone | 435-644-5626
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Fax |
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Provider Business Mailing Address
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Address Line | 329 S 350 E STE 4
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City | KANAB
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State | UT
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Zip | 84741-3768
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Country | US
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Telephone | 435-644-5626
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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 | 7742638-8900
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License Number State | UT
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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 | 856084
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License Number State | NV
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