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General NPI Number Information
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NPI Number | 1790233187
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Entity Type | Individual
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Provider Name | LINDA KAY BLASINGAME APRN
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Gender | Female
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 2725 N WESTWOOD BLVD STE 5
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-2367
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Country | US
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Telephone | 573-872-4675
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Fax | 573-872-4671
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Provider Business Mailing Address
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Address Line | 2725 N WESTWOOD BLVD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-2346
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Country | US
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Telephone | 573-872-4675
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Fax | 573-872-4371
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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 | R48867
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2021045824
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A005080
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2020012106
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License Number State | MO
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