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MRS. KRISTI LYNN BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1700 W SMITH VALLEY RD # UNITYC-1, GREENWOOD, IN 46142-1599
(317) 300-4091
Mailing address
6302 HARMONRIDGE CT, INDIANAPOLIS, IN 46278-2218
(317) 550-7292

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
100002703A
IN

Other

Enumeration date
11/17/2021
Last updated
11/17/2021
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