Individual
ELIZABETH BLAUVELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-9515
(812) 353-9275
Mailing address
PO BOX 1149, BLOOMINGTON, IN 47402-1149
(812) 353-3087
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006436A
IN
Other
Enumeration date
05/31/2016
Last updated
08/29/2016
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