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NPI Code Detail

MEDICARE: DEBRA LYNN BLAIR

MEDICARE:   DEBRA LYNN BLAIR
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1699421164
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA LYNN BLAIR
Provider Business Mailing Address
First Line : 5956 E NANCE ST
Second Line :
City : MESA
State : AZ
Zip : 85215
Country : US
Telephone Number : 480-385-9819
Fax Number :
Provider Business Practice Location Address
First Line : 5956 E NANCE ST
Second Line :
City : MESA
State : AZ
Zip : 85215
Country : US
Telephone Number : 480-385-9819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2022
Last Update Date : 02/23/2022

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Directions to “ DEBRA LYNN BLAIR ” Practice Location

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