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General NPI Number Information
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NPI Number | 1588185144
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Entity Type | Individual
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Provider Name | BENJAMIN ROBERT BLUE NP
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Gender | Male
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Dates
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Enumeration Date | 07/04/2017
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1 CHILDRENS PLZ
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City | DAYTON
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State | OH
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Zip | 45404-1873
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Country | US
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Telephone | 937-641-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 933432
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City | CLEVELAND
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State | OH
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Zip | 44193-0039
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Country | US
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Telephone | 937-641-5072
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Fax | 937-641-6129
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | APRN.CNP.020823
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License Number State | OH
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