Individual
JENNIFER REBECCA BLASTOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
193 MAIN ST, SUITE 1, NORWAY, ME 04268-5645
(207) 743-7721
(207) 743-6306
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP81266
ME
Other
Enumeration date
11/13/2006
Last updated
08/07/2012
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