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General NPI Number Information
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NPI Number | 1710276357
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Entity Type | Individual
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Provider Name | LEAH PARRISH BLAZER APRN
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Gender | Female
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 2630 E 7TH ST STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28204-4319
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Country | US
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Telephone | 704-355-9484
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Fax |
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Provider Business Mailing Address
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Address Line | 1423 BROCKENFELT DR
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City | CHARLESTON
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State | SC
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Zip | 29414-9122
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Country | US
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Telephone | 704-807-5678
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 15655
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5021356
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License Number State | NC
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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 | 23286
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License Number State | SC
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