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Individual
ABBY BLACKER
Active
Individual
ABBY BLACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209024207
IL
363LP0200X
Pediatric Nurse Practitioner
C125605
IA
Other
Enumeration date
02/11/2017
Last updated
05/19/2022
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