# PATRICIA LOUISE BLACKLEDGE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871586271
- **Gender:** F
- **Credential:** ARNP MS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 097156 | IA | — |
| 363L00000X | Nurse Practitioner | A097156 | IA | Yes |
| 363LF0000X | Family Nurse Practitioner | A097156 | IA | — |

## Other

- **Enumeration date:** 08/31/2005
- **Last updated:** 12/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3254342 | — | IA |
| 01 | — | 36504 | WELLMARK BCBS OF IA | IA |
| 01 | — | 420681060C4 | JOHN DEERE HEALTH | IA |