Individual
MS. JAIME CHRISTEN BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
(615) 444-6252
Mailing address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
(615) 444-6252
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13426
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12242142
CAQH
TN
01
—
13426
TN APRN LICENSE
TN
01
—
150001
TN RN LICENSE
TN
05
—
1519667
—
TN
01
—
3323078
UHC
TN
01
—
4250760
BCBS
TN
Enumeration date
05/09/2008
Last updated
08/09/2011
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