Individual
JEANNINE PATRICK-BLAIKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
292 FRANTZ RD, STE 108, STROUDSBURG, PA 18360-7455
(570) 426-2960
(570) 426-2965
Mailing address
206 E BROWN ST, EAST STROUDSBURG, PA 18301-3006
(570) 420-4951
(570) 476-3754
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
VP006532C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VP006532C
PA STATE LICENSE
PA
Enumeration date
03/21/2007
Last updated
11/06/2013
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