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Individual
BRIDGETTE C BLAIN
Active
Individual
BRIDGETTE C BLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A. - C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501057
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200371000A
—
KS
01
—
43346012
BCBSKC
KS
Enumeration date
07/07/2006
Last updated
03/30/2015
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