MEDICARE: MRS. CRYSTAL 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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1942162334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CRYSTAL BLAIR

Provider Business Mailing Address
First Line	:	10340 GLEN CIR APT 205
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-2969
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10340 GLEN CIR APT 205
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-2969
Country	:	US
Telephone Number	:	216-905-4113
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	02/06/2026

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