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Organization

PREVENTATIVE PRIMARY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHEILA MARIE BLANDING FNP (FAMILY NURSE PRACTITIONER)
(734) 225-6507
Entity
Organization

Contact information

Practice address
20600 EUREKA RD STE 522, TAYLOR, MI 48180-5373
(734) 225-6507
(734) 225-6513
Mailing address
20600 EUREKA RD STE 522, TAYLOR, MI 48180-5373
(734) 225-6507
(734) 225-6513

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704190451
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500H258620
BCBS
MI
Enumeration date
06/14/2010
Last updated
06/14/2010
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