Individual
BLAIR BAILEY WIENTJES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3101 PARISA DR, PADUCAH, KY 42003-4584
(270) 444-8477
(270) 444-8479
Mailing address
3101 PARISA DR, PADUCAH, KY 42003-4584
(270) 444-8477
(270) 444-8479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3013291
KY
363LF0000X
Family Nurse Practitioner
Primary
3013291
KY
Other
Enumeration date
02/18/2019
Last updated
08/26/2021
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