Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD-43378 | IA |
N | 208000000X | Pediatrician | R-9779 | IA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 54314 | AZ |
NPI | 1154769644 |
---|---|
Provider Name | Dr. Lindsay Rebecca Blick |
First Address | Phoenix, AZ 85016-7710 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2013 |
Last Update Date | 06/06/2017 |