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Individual
MRS. BECKY JEAN PRIDEAUX BLODGETT
Active
Individual
MRS. BECKY JEAN PRIDEAUX BLODGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30003968
WA
363L00000X
Nurse Practitioner
RN00089325
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500004687
MEDICARE OTHER-INDIVIDUAL
WA
01
—
AP30003968
LICENSE
WA
01
—
CO3401
MEDICARE OTHER-GROUP
WA
01
—
RN00089325
LICENSE
WA
Enumeration date
02/14/2006
Last updated
07/18/2019
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