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JO BLASENGAME AGACNP-BC

Acute Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1356005250

Individual Registrant:
 JO  BLASENGAME AGACNP-BC
Gender: F
Sole Proprietor

Location and contact information for practice:
2894 AUTUMN HILLS RD  STAR CITY, AR 71667-9554 US
Tel: 870-628-3842  Fax: --

Contact information for business:
2894 AUTUMN HILLS RD  STAR CITY, AR 71667-9554 US
Tel: 870-628-3842  Fax: --

Registration Information:
NPI: 1356005250
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Acute Care
AR217776

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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