Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 55048 | TN |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 01084364A | IN |
NPI | 1275875643 |
---|---|
Provider Name | Dr. Lindsay Jo Blazin |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300035326 | (05) | IN |