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NPI Code Detail

MEDICARE: BLUE SKIES MEDICAL INCORPORATED

MEDICARE: BLUE SKIES MEDICAL INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1364SF0001XFamily Health Clinical Nurse Specialist70000128AIN

General Provider Information

NPI Number : 1144649195
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE SKIES MEDICAL INCORPORATED
Provider Business Mailing Address
First Line : 2714 169TH ST
Second Line :
City : HAMMOND
State : IN
Zip : 46323-1508
Country : US
Telephone Number : 219-803-2246
Fax Number : 219-262-7810
Provider Business Practice Location Address
First Line : 2714 169TH ST
Second Line :
City : HAMMOND
State : IN
Zip : 46323-1508
Country : US
Telephone Number : 219-803-2246
Fax Number : 219-262-7810
Authorized Official
Title or Position : PRESIDENT
Name : DR. LISA GUZMAN
Credential : DNP
Telephone Number : 219-803-2246
Provider Enumeration Date : 04/07/2014
Last Update Date : 04/07/2014

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Directions to “BLUE SKIES MEDICAL INCORPORATED ” Practice Location

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