Individual
CAROLYN MAE BLOUIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3545 ARBOR BLVD STE E, PORTAGE, IN 46368-4298
(219) 947-6920
(219) 947-6921
Mailing address
3545 ARBOR BLVD STE E, PORTAGE, IN 46368-4298
(219) 947-6920
(219) 947-6921
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007816A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001565128
ANTHEM
IN
05
—
300012968
—
IN
Enumeration date
02/26/2018
Last updated
08/05/2022
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