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Individual
SUSAN LYNNE BLAKEMORE
Active
Individual
SUSAN LYNNE BLAKEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
A0213010
IN
363LF0000X
Family Nurse Practitioner
Primary
71004535A
IN
363LF0000X
Family Nurse Practitioner
F1214194
IN
Other
Enumeration date
08/28/2013
Last updated
04/30/2021
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