Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 4704068384 | MI |
N | 363LW0102X | Nurse Practitioner - Women's Health | 4704068384 | MI |
NPI | 1831303627 |
---|---|
Provider Name | Ms. Rosemary Blashill |
First Address | Sault Sainte Marie, MI 49783-1739 |
Second Address | Sault Sainte Marie, MI 49783-1976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4905004 | (05) | MI |
5008706660 | BCBS (01) | MI |