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NPI Code Detail

MEDICARE: ANNA LEE BLAZER

MEDICARE: ANNA LEE BLAZER
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
1235Z00000XSpeech-Language Pathologist30004553NC

General Provider Information

NPI Number : 1780417378
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA LEE BLAZER
Provider Business Mailing Address
First Line : 3901 WRIGHTSVILLE AVE STE 120
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6256
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3901 WRIGHTSVILLE AVE STE 120
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6256
Country : US
Telephone Number : 910-679-8385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2024
Last Update Date : 03/22/2026

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Directions to “ ANNA LEE BLAZER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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